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[Endoscopic parathyroidectomy via a lateral neck incision]
J F Henry1, T Defechereux, L Gramatica
1Service de Chirurgie Générale et Endocrinienne, Centre Hospitalier Universitaire La Timone, Marseille.
Annales De Chirurgie
|May 18, 1999
Summary
This study introduces a novel endoscopic parathyroidectomy technique using a lateral neck incision. The minimally invasive approach successfully treated primary hyperparathyroidism in 20 patients, demonstrating its efficacy and safety.
Area of Science:
- Endocrinology
- Minimally Invasive Surgery
- Surgical Oncology
Background:
- Traditional parathyroidectomy often involves larger incisions, potentially leading to increased morbidity.
- Endoscopic techniques offer potential advantages in reducing surgical trauma and improving cosmetic outcomes.
Purpose of the Study:
- To evaluate a new endoscopic parathyroidectomy approach utilizing a lateral neck incision.
- To assess the feasibility, safety, and efficacy of this minimally invasive technique for sporadic primary hyperparathyroidism.
Main Methods:
- A 15 mm transverse incision was made on the anterior border of the sternocleidomastoid muscle (SCM).
- Three trocars were inserted for endoscopic visualization and instrument manipulation under carbon dioxide insufflation (8 mmHg).
- Unilateral endoscopic parathyroid exploration was performed using a 10 mm-0 degree endoscopic camera, followed by adenoma extraction.
Main Results:
- Twenty patients with sporadic primary hyperparathyroidism underwent the procedure, with 14 adenomas localized pre-operatively.
- Video surgery identified 68% of explored parathyroid glands (86% of enlarged, 55% of normal).
- Mean operative time was 88 minutes, with 2 cases of superficial hematoma; all 20 patients were biochemically cured post-operatively.
Conclusions:
- Endoscopic parathyroid exploration via a lateral incision is a feasible and effective minimally invasive surgical option.
- This technique demonstrates good visualization of parathyroid glands and achieves biochemical cure for primary hyperparathyroidism.
- Further research may explore wider application and long-term outcomes of this approach.