Paratiroidectomia miniinvasiva videoassistita con accesso mediano. Evoluzione tecnica: Casistica 1999-2002

Translated title of the contribution: A minimally invasive video assisted technique for parathyroidectomy (MIVAP)

P. Miccoli, M. N. Minuto, M. Massi, L. Barellini, D. Galleri, J. D'Agostino, G. Materazzi, P. Berti

Research output: Contribution to journalArticle

Abstract

Introduction: In 1997 a Minimally Invasive Video Assisted Technique for Parathyroidectomy (MlVAP) was developed in the University of Pisa. In this review we examine the last three years of MIVAP (240 cases) in order to identify the advantages and the limits of the procedure after the first- period development of the technique. Results: In our experience, 65% of patients affected by primary hyperparathyroidism (PHPT) turned out to be eligible for MIVAP. During the first years several selection criteria were strictly followed; more recently, some initially absolute contraindications to the operation have been interpreted more flexibly. Mean operative time is 35 minutes. 18 conversions (7.5%) to traditional open cervicotomy were needed and in 4 cases (1.6%) no affected parathyroid tissue was removed. Conclusions: At present, we consider absolutely necessary for MIVAP: preoperative localization of an adenoma with at least one imaging study (US or MIBI scintiscan) and the availability of QPTH intraoperative assay. No absolute contraindications other than the size of the lesions and the suspect of parathyroid carcinoma are identified for patients with PHPT. Moreover, MIVAP has proved to have further advantages when compared to other mini invasive procedures such as the demonstrated possibility to perform a traditional bilateral exploration, when indicated. Nevertheless, a great degree of experience is requested for this procedure. In conclusion, MIVAP permits to significantly reduce postoperative pain, size of the incision, days of hospitalisation and, finally, the cost of the entire procedure without affecting in any way the success rate of the traditional operation and without an increase of the complications.

Translated title of the contributionA minimally invasive video assisted technique for parathyroidectomy (MIVAP)
Original languageItalian
Pages (from-to)407-412
Number of pages6
JournalAnnali Italiani di Chirurgia
Volume74
Issue number4
Publication statusPublished - Jul 2003

ASJC Scopus subject areas

  • Surgery

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    Miccoli, P., Minuto, M. N., Massi, M., Barellini, L., Galleri, D., D'Agostino, J., Materazzi, G., & Berti, P. (2003). Paratiroidectomia miniinvasiva videoassistita con accesso mediano. Evoluzione tecnica: Casistica 1999-2002. Annali Italiani di Chirurgia, 74(4), 407-412.