Totally endoscopic lateral parathyroidectomy: prospective evaluation of 200 patients

Fouquet, Thibaut; Germain, A; Zarnegar, Rasa; Klein, Marc; Talancé, Nicole de; Mayer, J; Ayav, Ahmet; Bresler, L.; Brunaud, Laurent

doi:10.1007/s00423-010-0687-1

Cited by 32 publications

(32 citation statements)

References 20 publications

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“…However, literature review and international surveys have also shown that most common approaches for minimally invasive parathyroidectomy correspond in fact to open focal mini-incision (about 70%), followed by videoassisted approach (about 20%), and totally endoscopic approach (about 10%) (1,3,7,12). Procedures that imply the utilization of the endoscope (totally endoscopic and videoassisted techniques) take advantage not only of the targeted approach, but also of the endoscopic magnification that allows performing the same intervention through a very minimal incision (7,10).…”

Section: Endoscopic Parathyroidectomy Without Robotic Systemmentioning

confidence: 99%

“…Carbon dioxide is insufflated at a pressure of 8 mmHg to expand the artificial space, and dissection is performed with 3-mm instruments ( Figure 1). During the procedure, identification of the recurrent laryngeal nerve and the ipsilateral parathyroid are often easily possible (3,7,15).…”

Section: Endoscopic Parathyroidectomy Without Robotic Systemmentioning

confidence: 99%

“…In the early 1980s, pioneers in the field began evaluating the success of performing parathyroidectomy without assessing all four glands. Unilateral exploration (one side) and then selective or focused parathyroid surgery (one gland) have been proposed since the introduction of improved preoperative localization studies and intraoperative parathyroid hormone (IOPTH) monitoring (3,4). Focused exploration is currently the standard technique for parathyroidectomy worldwide (1,(4)(5)(6).…”

Section: Introductionmentioning

confidence: 99%

“…As such, minimally invasive parathyroidectomy has become difficult to define and there is no current consensus on what defines minimally invasive parathyroidectomy (2). However, most endocrine surgeons agree that an incision of 2.5 cm or less with minimal dissection (adenoma excision and no dissection of the normal glands) fulfils the criteria (3,4,(6)(7)(8)(9).…”

Section: Introductionmentioning

confidence: 99%

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Endoscopic and robotic parathyroidectomy in patients with primary hyperparathyroidism

Brunaud¹,

Li²,

Heede³

et al. 2016

Gland Surg.

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Primary hyperparathyroidism (PHPT) is one of the most common endocrine disorders for which parathyroidectomy is the most effective therapy. Until late 1970s, the standard approach to parathyroidectomy was a four-gland exploration using a large skin incision. However, 80 to 85 percent of cases of PHPT are caused by a single adenoma. As such, the concept of performing a bilateral exploration in order to visualize all four glands has been argued to be excessive since in the majority of cases, there is only one abnormal gland. Focused exploration (one gland) is currently the standard technique for parathyroidectomy worldwide. Despite a rapid acceptance of minimally invasive approaches in most endocrine surgery centers, the use of an endoscope with or without the use of a robotic system to perform parathyroidectomy remains controversial. The goal of this study was to review current available data about surgical approaches using an endoscope with or without the use of a robotic system in the management of

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Section: Endoscopic Parathyroidectomy Without Robotic Systemmentioning

confidence: 99%

Section: Endoscopic Parathyroidectomy Without Robotic Systemmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Endoscopic and robotic parathyroidectomy in patients with primary hyperparathyroidism

Brunaud¹,

Li²,

Heede³

et al. 2016

Gland Surg.

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“…Besides the original description ( [11] Langenbecks Arch Surg) a large single-centre series using the totally endoscopic lateral approach for selective, minimally invasive parathyroidectomy, showing good postoperative shortterm results with a high rate (28%) of conversion to open exploration, is presented ( [6] Langenbecks Arch Surg, this issue)…”

mentioning

confidence: 99%

Surgical endocrinology—update 2010

Niederle

2010

Langenbecks Arch Surg

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Systematic review of cure and recurrence rates following minimally invasive parathyroidectomy

et al. 2018

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BackgroundThe majority of patients with primary hyperparathyroidism (PHPT) have a single overactive adenoma. Advances in preoperative imaging and surgical adjuncts have given rise to minimally invasive parathyroidectomy (MIP), with lower complication rates in comparison with bilateral neck exploration. Misdiagnosis and undertreatment of multiglandular disease, leading to potentially higher recurrence rates, remains a concern. This study evaluated risks of long‐term (1 year or more) recurrence following ‘targeted’ MIP in PHPT.MethodsMultiple databases were searched for studies published between January 2004 and March 2017, looking at long‐term outcomes (1 year or more) following targeted MIP for PHPT. English‐language studies, with at least 50 patients and a mean follow‐up of 1 year, were included.ResultsA total of 5282 patients from 14 studies were included. Overall mean recurrence and cure rates were 1·6 (range 0–3·5) and 96·9 (95·5–100) per cent respectively. Mean follow‐up was 33·5 (1–145) months. When intraoperative parathyroid hormone (PTH) measurements were not done, cure rates were higher (99·3 per cent versus 98·1 per cent with use of intraoperative PTH measurement; P < 0·001) and recurrence rates lower (0·2 versus 1·5 per cent respectively; P < 0·001).ConclusionTargeted MIP for a presumed single overactive adenoma was associated with very low recurrence rates, without the need for intraoperative PTH measurement when preoperative imaging studies were concordant. Targeted MIP should be encouraged.

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Totally endoscopic lateral parathyroidectomy: prospective evaluation of 200 patients

Abstract: Totally endoscopic lateral approach can be proposed in more than half of the patients with good immediate results. Conversion rate remains important and may explain low acceptance rate of this technique.

Cited by 32 publications

References 20 publications

Endoscopic and robotic parathyroidectomy in patients with primary hyperparathyroidism

Endoscopic and robotic parathyroidectomy in patients with primary hyperparathyroidism

Surgical endocrinology—update 2010

Systematic review of cure and recurrence rates following minimally invasive parathyroidectomy

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