Endoscopic parathyroidectomy

During the last three years, minimally invasive procedures have been adopted for the surgical treatment of primary hyperparathyroidism, because preoperative localization studies such as a high-resolution ultrasonography and sestamibi scintigraphy, guidance by intraoperative scans and the use of a quick, intraoperative PTH assay, have improved. Therefore, endoscopic parathyroidectomy can be performed for patients with primary hyperparathyroidism. The endoscopic procedures range from the 'pure' endoscopic approach characterized by constant gas insufflation and video-assisted gasless techniques. Then, we regard the cosmetic result as important, and adopted the 'pure' endoscopic approach because a small incision can be made far from the neck region. We report our technique with no scars in the neck region for endoscopic unilateral neck exploration with primary hyperparathyroidism by an axillary approach and for endoscopic bilateral neck exploration with renal hyperparathyroidism by an anterior chest approach. (C) 2000 Editions scientifiques et medicales Elsevier SAS.