One hundred consecutive minimally invasive parathyroid explorations
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Updated: Oct 13, 2026
Gasless Endoscopic Thyroidectomy via the Trans-Axillary Approach
Published on: September 15, 2023
R Udelsman1, P I Donovan, L J Sokoll
1Departments of Surgery and Pathology, Johns Hopkins Medical Institutions, Baltimore, Maryland 21287, USA. rudelsma@jhmi.edu
Objective:
To review the outcomes of 100 consecutive minimally invasive parathyroid explorations.
Summary Background Data:
Minimally invasive parathyroidectomy (MIP) has challenged the traditional approach of bilateral neck exploration for patients with primary hyperparathyroidism. Most patients with primary hyperparathyroidism have a single adenoma that when resected results in cure. It therefore appears logical to perform a directed approach to adenoma extirpation. MIP involves high-quality sestamibi images obtained with single photon emission computed tomography to localize enlarged parathyroid glands in three dimensions, limited exploration after surgeon-administered cervical block anesthesia, rapid intraoperative parathyroid hormone assay to confirm the adequacy of resection, and discharge within 1 to 3 hours of surgery.
Methods:
MIP was offered to 100 selected consecutive patients during an 18-month period beginning in March 1998.
Results:
Ninety-two cases were accomplished under cervical block anesthesia and 89 of these on an ambulatory basis. The cure rate was 100%, and there were no long-term complications. The mean hospital charge for MIP was less than 40% of that associated with traditional exploration.
Conclusions:
Outpatient MIP appears to be the procedure of choice for most patients with primary hyperparathyroidism.
