Minimally invasive, endoscopic assisted, parathyroidectomy (MIEAP) with intraoperative methylene blue (MB) identification

BackgroundMore than 85% of patients with primary hyperparathyroidism (PHPT) have a single adenoma. This fact when combined with the recent advances in preoperative imaging diagnostic modalities and intraoperative identification of the diseased gland has allowed the development of minimally invasive endoscopic assisted parathyroidectomy (MIEAP).ObjectiveTreatment of patients with primary hyperparathyroidism due to a single gland disease, with minimally invasive endoscopic-assisted parathyroidectomy.Subjects and methodsNine patients (seven females and two males) with PHPT were proved to have a single-gland parathyroid adenoma after preoperative imaging techniques. They were scheduled for MIEAP, with intraoperative identification by MB.ResultsSurgical time ranged between 21 and 35 min through a small surgical wound and cure rate of 100% with no recorded complications.ConclusionMIEAP is an easy, safe and effective maneuver for management of PHPT due to a localized adenoma. It is less costly with a cosmetically-accepted wound.