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. 2003 Jun;90(6):743-7.
doi: 10.1002/bjs.4183.

Limits and drawbacks of video-assisted parathyroidectomy

P Berti  1 , G Materazzi, A Picone, P Miccoli
Affiliations

Limits and drawbacks of video-assisted parathyroidectomy

P Berti et al. Br J Surg. 2003 Jun.

Abstract

Background: Minimally invasive video-assisted parathyroidectomy (MIVAP) is a novel minimally invasive approach to primary hyperparathyroidism (PHPT). It is a gasless operation characterized by a single central incision and external retraction. This paper describes the drawbacks and limitations of this procedure based on a 5-year experience and 260 operations.

Methods: Of 364 patients with PHTP, 260 were selected for MIVAP. In most patients a unilateral minimally invasive exploration was performed.

Results: MIVAP was carried out successfully in 239 patients with a mean operating time of 40 (range 20-180) min. Conversion to cervicotomy was required in 21 patients (8.1 per cent). Complications included recurrent nerve palsy in two patients (0.8 per cent), haemorrhage that required reoperation 6 h after parathyroidectomy in one patient (0.4 per cent) and transient hypoparathyroidism in six patients (2.5 per cent). In five patients (2.1 per cent) persistent PHPT developed shortly after surgery.

Conclusion: After 5 years of experience, MIVAP appears to be feasible, safe and applicable to the majority of patients with PHPT.

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