Related Experiment Video
Updated: Aug 10, 2026
Gasless Endoscopic Thyroidectomy via the Trans-Axillary Approach
Published on: September 15, 2023
Conventional bilateral cervical exploration versus open minimally invasive parathyroidectomy under local anaesthesia
A Bergenfelz1, V Kanngiesser, A Zielke
1Department of Surgery, Philipps-University Marburg, Baldingerstrasse, D-35033 Marburg, Germany.
Background:
Minimally invasive parathyroidectomy (MIP) has been introduced for the treatment of patients with primary hyperparathyroidism (pHPT). Thus far, only one randomized trial has compared video-assisted MIP with conventional bilateral cervical exploration (BCE). The value of open MIP is therefore not known.
Methods:
Fifty patients with a solitary parathyroid adenoma localized before surgery by sestamibi scintigraphy were randomized to undergo BCE under general anaesthesia (n = 25) or targeted MIP via a 2-cm incision using local anaesthesia (n = 25). Postoperative hypocalcaemia was the primary endpoint. Secondary outcome measures were operating time, complications, postoperative analgesia and recurrent disease. Follow-up was carried out at 1 and 6 months.
Results:
All patients who underwent BCE and 24 of those who had MIP were cured by the primary operation. Operating time was 22 min shorter in the MIP group (P = 0.024). Serum levels of calcium were slightly lower during the first 4 days after surgery in the BCE group (P = 0.022). No other no significant differences were found.
Conclusion:
Targeted MIP using local anaesthesia reduces operating time and causes less postoperative biochemical hypocalcaemia compared with bilateral neck exploration.
