One hundred consecutive minimally invasive parathyroid explorations

Objective To review the outcomes of 100 consecutive minimally invasive para thyroid explorations. Summary Background Data Minimally invasive parathyroidectomy (MIP) has chal lenged the traditional approach of bilateral neck exploration for patients with primary hyperparathyroidism. Most patients with primary hyperparathyro idism have a single adenoma that when resected results in cure. It therefor e appears logical to perform a directed approach to adenoma extirpation. MI P involves high-quality sestamibi images obtained with single photon emissi on computed tomography to localize enlarged parathyroid glands in three dim ensions, limited exploration after surgeon-administered cervical block anes thesia, rapid intraoperative parathyroid hormone assay to confirm the adequ acy of resection, and discharge within I to 3 hours of surgery. Methods MIP was offered to 100 selected consecutive patients during an 18-m onth period beginning in March 1998. Results Ninety-two cases were accomplished under cervical block anesthesia and 89 of these on an ambulatory basis. The cure rate was 100%, and there w ere no long-term complications. The mean hospital charge for MIP was less t han 40% of that associated with traditional exploration. Conclusions Outpatient MIP appears to be the procedure of choice for most p atients with primary hyperparathyroidism.