Minimally Invasive Parathyroidectomy Under Local Cervical Block Anesthesia for Primary Hyperparathyroidism and Parathyroid Adenoma
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Procedure Outline
Table of Contents
- Patient Positioning
- Marking
- Inject Anesthesia for Local Cervical Block
- Kocher Incision
- Use a 2.5–3.5-cm abbreviated Kocher incision
- Create Subplatysmal Flaps
- Open Strap Muscles at the Midline
- Mobilize Thyroid
- Mobilize thyroid medially
- Ligate the middle thyroid vein
- Retract the thyroid medially
- Mobilize Parathyroid Adenoma
- Identify the left inferior parathyroid adenoma
- Handle the parathyroid adenoma gently to avoid rupture of the capsule
- Ligate End Arterial Blood Supply and Finish Parathyroid Resection
- Use the silk tie to elevate the parathyroid adenoma out of the tracheoesophageal groove
- Perform ex vivo aspiration and PTH measurement of the left inferior parathyroid adenoma
- Measure PTH in the systemic circulation, preoperatively, at the time of excision, and every 5 minutes thereafter
- Close Strap Muscles at Midline
- Close Platysma Muscles
- Close Dermis with 5-0 Prolene
- Apply Dermabond and Steri-Strips
- Remove Suture