Minimally Invasive Radio-guided Parathyroid Surgery

Korean Journal of Head & Neck Oncology 1999;15(2):194-199.
Published online November 30, 1999.

Woong Yoon Chung,;Hang Seok Chang;Jong Doo Lee;Cheong Soo Park

최소침습 방사능 유도 부갑상선 수술

정웅윤;장항석;이종두;박정수

Abstract

Introduction: Since 1996, Dr. James Norman has successfully performed mimimally invasive radio-guided parathyroidectomy(MIRP) using intraoperative nuclear mapping with 99m Tc sestamibi scanning and radioactivity detection probe. Objectives: We aimed to introduce this new surgical technique and evaluate it's efficacy by our own experiences. Method: From May to October 1999, five consecutive patients with primary hyperparathyroidism underwent parathyroidectomy by using modified MIRP technique. 99m Tc sestamibi scanning was performed 1.0 or 1.5 hour before operation. After intraoperative localization of the tumor under the guidance of quantitative gamma counting with a NEVIGATOR probe, an unilateral small skin incision(3.0-4.0cm) was placed. Without a skin flap, the strap muscle was directly divided with the use of a Harmonic scalpel. After careful dissection, the parathyroid tumor was removed. Result: In all patients, a single adenoma could be easily detected and removed by this new technique. Mean incision length was 3.2cm(3.0-4.0cm) and operative time ranged from 40 to 110minute. All the patients were discharged within 2 days of surgery without any complication.
Conclusion
This new operative technique could become the most minimally invasive alternative to the standard operative procedure for parathyroid adenoma.

Key Words: Radio-guided parathyroidectomy