BookAlexander Shifrin, editor.
Summary: This Atlas is designed to illustrate different techniques on how to perform successful parathyroidectomy by using traditional four gland exploration approach and minimally invasive approaches, such as the open minimally invasive approach, video-assisted approach, back-door approach, transoral endoscopic parathyroidectomy approach (TOEPVA), and endoscopic lateral parathyroidectomy approach. It illustrates removal of a right and left, and superior and inferior parathyroid glands. Written by renowned endocrine surgeons and experts in the field, each chapter begins with a case description that defines the main aspect of surgery. Each picture, which is taken intraoperatively, is accompanied by corresponding drawings for easier understanding of the anatomical structures and steps of the procedure. In addition, most of the authors provided a video of the same case as it is depicted in the chapter. The Atlas also gives some common pitfalls of the procedure in an effort to avoid complications and improve patient outcomes. Atlas of Parathyroid Surgery provides an indispensable source of knowledge to all surgeons, those who just started their career, and those who are in the more advanced stages of their practice and are learning new techniques of parathyroidectomy.
Contents:
Intro
Preface
Acknowledgments
Contents
Contributors
1: Bilateral Exploration for Hyperparathyroidism
Introduction
Preoperative Considerations for Confirmed Hyperparathyroidism
Indications
Advantages of Bilateral Approach
Disadvantages of Bilateral Approach
Preoperative Assessment
Confirmation of Diagnosis
Assessment of Symptoms and End-Organ Effects
Preoperative Imaging
Informed Consent
Instruments Required
Patient Positioning and Theater Setup
Operative Steps and Technique
Incision and Exposure
Mobilization of Strap Muscles Lateral Mobilization of Thyroid Gland and Identification and Ligation of Middle Thyroid Vein
Identification of Parathyroid Glands
Pearls for Identification of Parathyroid Glands
Identification of Superior Parathyroid Gland
Exposure of the Prevertebral Fascia
Visual
Digital
Identification of Inferior Parathyroid Gland
Visual
Additional Maneuvers
Identification of the Recurrent Laryngeal Nerve
Extent of Parathyroidectomy
Single Adenoma (1 Abnormal Gland/3 Normal Glands)
Double Adenoma (2 Abnormal Glands/2 Normal Glands) Four-Gland Hyperplasia (4 Abnormal Glands)
Removal of Morphologically Abnormal Gland(s)
Auto-transplantation
Management of Intra-operative Complications
Bleeding
Nerve Injury
Closure
Special Scenarios
Familial/Genetic Hyperparathyroidism
Concomitant Thyroid Pathology
Postoperative Management
Postoperative Investigations
Postoperative Complications
Hematoma
Hypocalcemia
Follow-Up
References
2: Four-Gland Parathyroid Exploration: Subtotal Parathyroidectomy
Introduction
Procedure Steps
Augusta Renal Protocol
References 3: Bilateral Neck Exploration and Subtotal Parathyroidectomy for Primary Hyperparathyroidism Due to Asymmetric Multiglandular Hyperplasia
Introduction
Surgical Procedure
Suggested Reading
4: Parathyroidectomy
Introduction
Procedure
References
5: Minimally Invasive Right Inferior Parathyroidectomy
Introduction
Case Description
References
6: Minimally Invasive Video-Assisted Parathyroidectomy: How to Correctly Approach the Adenoma
Introduction
Indications
Operative Technique
Patients and Surgical Team Position
Anesthesia
Surgical Technique The Importance of the Surgeon's Knowledge of Embryology and Anatomy
The Importance of Surgeon's Performed Ultrasound (US) Before Parathyroidectomy
Results of MIVAP
References
7: Minimally Invasive Left Superior Parathyroidectomy: Anterior Approach
Introduction
Case Description
References
8: Minimally Invasive Parathyroidectomy: Targeted Left Inferior Parathyroidectomy
Introduction
Case Description
References
9: Video-Assisted Left Superior Parathyroidectomy
Introduction
Procedure
Patient position
Instruments set:
References