Radio-guided procedure in minimally invasive surgery for primary hyperparathyroidism.

Area of Science:

• Endocrine Surgery
• Nuclear Medicine
• Surgical Oncology

Background:

• Minimally invasive parathyroidectomy is the standard for primary hyperparathyroidism.
• Preoperative localization using MIBI scintigraphy (SPECT/CT) and ultrasound is crucial.
• Radioguided surgery offers enhanced efficacy and verification.

Purpose of the Study:

• To detail the indications, protocols, and differences between MIBI and Radio-guided Occult Lesion Localization (R.O.L.L.) procedures.
• To highlight the advantages of radioguided minimally invasive parathyroidectomy.
• To compare available radioguided parathyroid surgery techniques.

Main Methods:

• Review of indications and protocols for MIBI and R.O.L.L. procedures.
• Comparison of radioguided techniques in minimally invasive parathyroidectomy.
• Analysis of benefits including shortened surgical times and minimal complications.

Main Results:

• Radioguided minimally invasive parathyroidectomy demonstrates high detection rates for parathyroid adenomas.
• The technique is particularly beneficial for ectopic lesions and patients with prior neck surgery.
• Immediate verification of adenoma removal is possible, reducing reoperation rates.

Conclusions:

• Radioguided minimally invasive parathyroidectomy is a highly effective technique for primary hyperparathyroidism.
• MIBI and R.O.L.L. offer distinct advantages in parathyroid adenoma localization and removal.
• This approach enhances surgical precision, reduces operative time, and minimizes complications.