Modified Open Mini-Incision Parathyroidectomy for Solitary Parathyroid Adenoma "Cosmetic andEffective"

Objective:Minimally invasive techniques are becoming more widespread in today’s daily endocrine surgery practice. The main aim of this study was to evaluate the applicability of the new modified open minimally invasive parathyroidectomy (MO-MIP) technique in patients with solitary (single) parathyroid adenoma, without the use of auxiliary methods (such as the use of intra-operative parathyroid hormone measurement or gamma probe device). Materials and Method: Only the patients with a concordant ultrasound scan (USS) and MIBI scans (MIBIS) were selected for the study. In addition, 24 PHPT patients who underwent MO-MIP and were operated on by a single surgeon in a single centre were evaluated. Records of patients were reviewed especially for pre-operative symptoms, pre-operative localisation imaging, operation findings, pre- and post-operative biochemical findings, and any observed complications. Results: Right-sided adenomas (15/24) were more common than left-sided lesions (9/24). The mean pre-operative parathyroid hormone (PTH) level was 269.2 pmol/l, whereas the mean post-operative (24 h) PTH level was 22.2 pmol/l (p = 0.0001). The mean pre-operative serum calcium level was 11.5 mmol/l, and the mean post-operative (24 h) calcium level was 8.9 mmol/l (p = 0.001). The short-term follow-up cure rate was 100%. Conclusion: MO-MOP, performed by an experienced surgeon, can be used effectively and safely, with better aesthetic results, in the treatment of solitary parathyroid adenoma.