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Gasless Endoscopic Thyroidectomy via the Trans-Axillary Approach

Gasless Endoscopic Thyroidectomy via the Trans-Axillary Approach

Published on: September 15, 2023

Endoscopic parathyroidectomy using a three-port submental approach.

Patorn Piromchai¹

¹Department of Otorhinolaryngology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand. patorn@gmail.com.

Langenbeck'S Archives of Surgery

|March 15, 2020

Summary

This study shows that the three-port submental endoscopic approach is effective for parathyroidectomy in challenging tertiary hyperparathyroidism cases. The procedure resulted in significant reductions in parathyroid hormone and calcium levels with minimal scarring.

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Area of Science:

Endocrine Surgery
Minimally Invasive Surgery
Head and Neck Surgery

Background:

The three-port submental endoscopic approach has been utilized for thyroidectomy since 2016.
Its application in parathyroidectomy, particularly for complex cases, has not been previously reported.

Purpose of the Study:

To report the initial experience with the three-port submental endoscopic approach for parathyroidectomy.
To evaluate its efficacy in challenging cases, specifically tertiary hyperparathyroidism.

Main Methods:

A retrospective comparison of outcomes before and after parathyroidectomy.
Utilized a three-port submental endoscopic approach for parathyroid gland removal.

Main Results:

Keywords:

Endoscopic parathyroidectomy Hyperparathyroidism Parathyroidectomy Submental Submental endoscopic parathyroidectomy

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Five patients with tertiary hyperparathyroidism underwent endoscopic subtotal parathyroidectomy.

Significant decreases in parathyroid hormone (mean difference 2260 pg/ml) and calcium levels (mean difference 2.84 mg/dl) were observed.

No major adverse events were reported during the study period.

Conclusions:

The submental approach enables visualization of all parathyroid glands.
This technique results in minimal, concealed surgical scarring.
Promising surgical outcomes with no major complications were achieved.