Intraoperative radioguided thoracoscopic removal of ectopic parathyroid adenoma

Twenty-five percent of primary hyperparathyroidism is caused by ectopic med iastinal parathyroid glands, with 2% of these not accessible to standard ce rvical surgical approaches. Advancement in video-assisted thoracoscopic sur gical techniques has decreased the need for sternotomy to successfully remo ve these ectopic glands. The thoracoscopic approach, however, is limited by the surgeon's inability to, always accurately visualize ectopic glands. In traoperative radionuclide-guided dissection, using a thoracoscopic approach , provides a novel adjunct to the removal of occult ectopic parathyroid gla nds. We report a case of an occult ectopic parathyroid adenoma removed thor acoscopically using an intraoperative handheld gamma probe. (C) 2001 by The Society of Thoracic Surgeons.