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Updated: Jun 17, 2026

Gasless Endoscopic Thyroidectomy via the Trans-Axillary Approach
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Gasless Endoscopic Thyroidectomy via the Trans-Axillary Approach

Published on: September 15, 2023

[Minimally invasive surgery for hyperparathyroidism].

Waldemar Trolle1, Henrik Møller, Finn Noe Bennedbaek

  • 1Øre-naese-halskirurgisk Afdeling, Gentofte Hospital, DK-2900 Hellerup, Denmark. watr@geh.regionh.dk

Ugeskrift for Laeger
|January 9, 2010
PubMed
Summary
This summary is machine-generated.

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The Parathyroid Glands00:59

The Parathyroid Glands

The two pairs of parathyroid glands embedded within the posterior surface of the thyroid gland are restricted by a dense capsule around them. These glands comprise two distinct cell populations—parathyroid oxyphil and parathyroid principal cells- pivotal in calcium homeostasis.
Oxyphil cells, whose functions remain elusive, emerge during late puberty, adding a layer of complexity to the parathyroid gland's intricacies. In contrast, principal parathyroid cells undertake a vital role by producing...

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Minimal invasive parathyroidectomy for primary hyperparathyroidism (PHPT) offers a safe and effective alternative to traditional surgery. This approach is less time-consuming, has a low complication rate, and yields comparable or better success rates.

Area of Science:

  • Endocrinology
  • Surgical Oncology
  • Minimally Invasive Surgery

Background:

  • Traditional bilateral neck exploration for primary hyperparathyroidism (PHPT) involves extensive gland assessment.
  • Advancements in imaging and intraoperative parathyroid hormone (PTH) monitoring enable focused surgical approaches.
  • Minimal invasive parathyroidectomy offers a less invasive alternative.

Purpose of the Study:

  • To evaluate the outcomes of minimal invasive parathyroidectomy for PHPT.
  • To compare the efficacy and safety of minimal invasive parathyroidectomy with traditional bilateral exploration.

Main Methods:

  • A consecutive series of 116 patients (117 procedures) with PHPT underwent minimal invasive parathyroidectomy.
  • Preoperative sestamibi scintigraphy and perioperative PTH measurements were utilized.

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  • Surgical approach was unilateral in 80 patients and minimally invasive in 56.

    • Main Results:

    • Sestamibi scintigraphy correctly identified the pathological gland in 65% of cases.
    • Pathological glands were found in 96.6% of procedures.
    • The median operative time for minimal invasive surgery was 35 minutes, compared to 55 minutes for traditional methods.
    • No permanent vocal cord paralysis occurred; persistent hypercalcemia and recurrence rates were low.

    Conclusions:

    • Minimal invasive parathyroidectomy demonstrates equivalent or superior success rates compared to bilateral neck exploration for PHPT.
    • This approach is safe, time-efficient, and associated with a low complication rate.
    • Advantages include reduced surgical trauma, improved cosmetic outcomes, and rare postoperative hypocalcemia.