Minimally invasive parathyroidectomy and thyroidectomy--current concepts

The introduction of various techniques for minimally invasive parathyroidectomy (MIP) and minimally invasive thyroid surgery (MITS) have changed both the conceptual and surgical approach to parathyroid disease and single thyroid nodules. Perceived advantages of minimally invasive surgery both among clinicians and patients, have been a major factor in the development of new surgical techniques, as well as refinement in preoperative localisation techniques. Worldwide the number of patients being operated on using MIP or MITS has steadily increased. At some major centres as many as 70% of patients with primary hyperparathyroidism have their operation using MIP. In this review we discuss the underlying pathology and investigative procedures, as well as the various techniques used, all of which now have excellent outcomes at a minimal cost and with minimal complications. Based on our own experience we recommend the use of a lateral focused mini-incision for both MIP and MIT since they both use standard equipment and standard dissection techniques familiar to all experienced endocrine surgeons.