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  • Title
  • 1. Introduction
  • 2. Incision
  • 3. Exposure of Thyroid Gland and Overlying Strap Muscles
  • 4. Exposing and Exploring all Four Parathyroid Glands
  • 5. PTH Check and Hemostasis with Surgicel
  • 6. Closure and PTH Check
  • 7. Post-op Remarks

Parathyroidectomy and Four-Gland Exploration for Hyperparathyroidism

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Allison S. Letica-Kriegel, MD, MSc; Antonia E. Stephen, MD
Massachusetts General Hospital

General Surgery

Procedure Outline

Table of Contents

  1. 1. Introduction
    1. 2. Incision
      1. 3. Exposure of Thyroid Gland and Overlying Strap Muscles
        1. 4. Exposing and Exploring all Four Parathyroid Glands
          1. 5. PTH Check and Hemostasis with Surgicel
            1. 6. Closure and PTH Check
              1. 7. Post-op Remarks
                1. Subplatysmal Flaps
                2. Separate Strap Muscles
                1. Left Inferior Parathyroid with Removal: Most Suspicious on Pre-op Imaging
                2. Left Superior Parathyroid
                3. Right Inferior Parathyroid
                4. Right Superior Parathyroid
                5. Summary of Findings
                6. Further Exploration of Left Superior Parathyroid
                7. Re-evaluation and Preservation of Right Inferior Parathyroid
                8. Re-evaluation and Removal of Right Superior Parathyroid
                9. Summary of Progress and Comparison with Expectations from Pre-op Imaging
                10. Return to Right Inferior Parathyroid Gland for Biopsy
                1. Sternohyoid Muscle with 4-0 Vicryl Interrupted Sutures
                2. Platysma with 4-0 Vicryl Interrupted Sutures
                3. Skin with Running, Knotless 5-0 Monocryl Subcuticular Suture and Steri-Strips

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                Authors

                Filmed At:

                Massachusetts General Hospital

                Article Information

                Publication Date
                Article ID463
                Production ID0463
                Volume2025
                Issue463
                DOI
                https://doi.org/10.24296/jomi/463