Outpatient minimally invasive parathyroidectomy using local/regional anesthesia: A safe and effective operative approach for selected patients

Cohen, Mark S.; Finkelstein, Steven E.; Brunt, L. Michael; Haberfeld, Elizabeth; Kangrga, Ivan; Moley, Jeffrey F.; Lairmore, Terry C.

doi:10.1016/j.surg.2005.07.016

Cited by 62 publications

(51 citation statements)

References 25 publications

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“…In our method we think that only ten cases are enough for a learning curve, because we perform US in the presence of a radiologist, not a surgeon alone. While MIP was completed successfully in 84% of patients (under local anesthesia) in one study [31], the completion rate was 100% for us. One should consider that proper patient selection and the experience of the surgical team play an important role in the conversion rate.…”

Section: Discussionmentioning

confidence: 89%

“…The solitary adenoma causes 85-90% of all pHPT [27][28][29]. For single gland disease, MIP can be applied securely and efficiently with local anesthesia and intravenous (IV) sedation [30][31][32][33].…”

Section: Discussionmentioning

confidence: 99%

“…Many studies about MIP mention the anterior approach [30][31][32]. In the lateral approach the gland is reached by splicing the anterior wall of the sternocleidomastoid muscle and lateral border of the strap muscles via a small skin incision [30,33].…”

Section: Authormentioning

confidence: 99%

“…In literature the mean operation time of MIP ranges from 15 to 56 minutes [30,31]. It also shortens the hospitalization time [25].…”

Section: Authormentioning

confidence: 99%

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Improvement of minimally invasive parathyroidectomy outcomes by real time ultrasonography performed by a surgeon and radiologist team.

et al. 2015

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Aims: Minimally invasive parathyroidectomy (MIP) has become the first line of treatment for primary hyperparathyroidism caused by solitary parathyroid adenoma. In order to increase the sensitivity of high-resolution ultrasonography (hUS), surgeon performed ultrasonography (SUS) has been increasingly used preoperatively. However, a radiologist and surgeon performing ultrasonography (RSUS) has not been a usual practice. In this study, we aimed to evaluate the clinical contribution of RSUS on MIP. Material and methods: From 2012 to 2014, a total of 30 consecutive patients (4 male, 26 female, mean age 48.87±14.52 years) with solitary parathyroid adenoma, were included in the study. All patients underwent preoperative hUS and Technetium-99m sestamibi scintigraphy. In patients, demographic characteristics, diagnostic tools used, levels of biochemical parameters, duration of operation, and length of hospital stay were recorded. Results: Adenomas were successfully localized by US in all patients and the surgical approach was determined according to this localization. Parathyroidectomy with MIP was successfully performed under local anesthesia in all patients. Mean operation time was 19.87±3.35 min. Postoperative PTH and calcium values were significantly decreased. All patients were discharged from the hospital in the same day. None of the patients had complications such as recurrent laryngeal nerve injury, hematoma, or injury to nearby organs. None of the patients had drains placed. Conclusions: Adenoma is well localized by US and thus, MIP can be completed under local anesthesia. US provides a very important clinical contribution to the success of MIP. In addition to these, RSUS helps in determining the location of the incision and the shortest way to achieve the lesion; therefore, it provides a small incision and shortens duration of the operation with a minimal dissection.

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Authormentioning

confidence: 99%

“…In literature the mean operation time of MIP ranges from 15 to 56 minutes [30,31]. It also shortens the hospitalization time [25].…”

Section: Authormentioning

confidence: 99%

See 2 more Smart Citations

Improvement of minimally invasive parathyroidectomy outcomes by real time ultrasonography performed by a surgeon and radiologist team.

et al. 2015

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show abstract

“…Long duration of surgery, postoperative bleeding, pain, nausea and vomiting are the most common factors associated with unanticipated admission.. Proper selection of patients, minimally invasive surgical techniques, 104 and implementation of multiple clinical pathways to deal with postoperative complications in the PACU and ASU can reduce the likelihood of unanticipated hospital admission.…”

Section: Unanticipated Hospital Admissionmentioning

confidence: 99%