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Updated: Dec 9, 2025
Gasless Endoscopic Thyroidectomy via the Trans-Axillary Approach
Published on: September 15, 2023
Image-guided Endoscopic Parathyroidectomy Using the Axillo-breast Approach in the Treatment of Primary
Islam A Elzahaby1, Amr Abouzid, Saleh Saleh
1Department of Surgical Oncology, Mansoura Oncology Center, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Background:
Focused parathyroidectomy is currently performed using minimal access techniques. Here, we aim to evaluate the outcomes of the axillo-breast totally endoscopic approach (ABTEA) in patients with primary hyperparathyroidism caused by a single parathyroid adenoma.
Patients And Methods:
Ten patients with primary hyperparathyroidism were retrospectively evaluated. In all patients, the presence of a single parathyroid adenoma was confirmed using cervical ultrasonography by an expert radiologist with or without the use of parathyroid scintigraphy. All patients underwent focused parathyroidectomy using ABTEA. Clinicopathologic characteristics, surgical outcomes, biochemical cure rates, and cosmetic outcomes were evaluated.
Results:
The parathyroid adenoma was successfully excised in all patients without significant complications and without conversion to open approach. All patients were cured, with ≥6 months of follow-up. Temporary hoarseness of the voice was observed in 1 case. The mean surgical time was 91±17.61 minutes. The mean blood loss was 20 mL. The postoperative pain scores were satisfactory and 90% of patients were extremely satisfied with the procedure.
Conclusion:
With accurate preoperative sonographic localization of a single parathyroid adenoma, focused parathyroidectomy using ABTEA is a safe and feasible technique even for posteriorly located parathyroid adenomas.
