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Related Experiment Video

Updated: Nov 8, 2025

Gasless Endoscopic Thyroidectomy via the Trans-Axillary Approach
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Minimally Invasive Parathyroidectomy: Are Auxiliary Methods Necessary?

Hakan Bolukbasi1, Serhan Yılmaz1, Erkan Somuncu1

  • 1Department of General Surgery, University of Health Sciences, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey.

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
|April 19, 2021
PubMed
Summary

Parathyroid scintigraphy accurately locates parathyroid (PT) glands for minimally invasive parathyroidectomy (MIP). Ultrasound is a secondary option, with MIP showing high success rates in treating primary hyperparathyroidism.

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Area of Science:

  • Endocrinology
  • Surgical Oncology
  • Nuclear Medicine

Background:

  • Primary hyperparathyroidism (PHPT) is a common endocrine disorder.
  • Minimally invasive parathyroidectomy (MIP) is a standard surgical treatment for PHPT.
  • Accurate preoperative localization of parathyroid (PT) glands is crucial for successful MIP.

Purpose of the Study:

  • To evaluate the success rate of MIP using preoperative scintigraphy and ultrasonography.
  • To determine the sufficiency of these imaging modalities for PT gland localization.
  • To assess the efficacy of MIP in treating primary hyperparathyroidism.

Main Methods:

  • Observational study of 61 patients with PHPT undergoing MIP.
  • Preoperative localization of PT glands using Tc-99m methoxyisobutylisonitrile (MIBI) scintigraphy and ultrasonography.

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  • Analysis of pre- and postoperative serum calcium, parathormone, and phosphorus levels.

    • Main Results:

    • Parathyroid scintigraphy achieved 100% accuracy in PT gland localization.
    • Ultrasonography was unsuccessful in 5 patients.
    • MIP resulted in significantly reduced postoperative parathormone and calcium levels (p <0.001), with an 8.2% rate of persistent hyperparathyroidism.

    Conclusions:

    • Parathyroid scintigraphy is the gold standard for preoperative PT gland localization.
    • Ultrasonography is a useful secondary localization technique.
    • MIP is a successful treatment for primary hyperparathyroidism when guided by appropriate imaging.