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Robotic Parathyroidectomy

  • Salem I. NoureldineEmail author
  • Fadi Murad
  • Emad Kandil
  • Ralph P. TufanoEmail author
Chapter

Abstract

With the advances in preoperative localization studies and greater demand for less-invasive procedures, novel targeted approaches to the parathyroid glands have been described and practiced over the past two decades. Despite the various surgical options, no single technique has been established as superior to another. The da Vinci Si Surgical Robot System is considered to be the latest addition to the endocrine surgeon’s armamentarium to accomplish remote-access, targeted parathyroidectomy. Its application in head and neck surgery has gained wide popularity in Asia and recently in European and North American practice. Robotic parathyroidectomy overcomes the limitations of conventional endoscopic surgery while avoiding a cervical scar by concealing it in the axilla, infraclavicular area, or the retroauricular area. The evidence from the present review shows that robotic parathyroidectomy is equivalent to conventional, targeted parathyroidectomy with regards to cure and complication rates. As with every surgical technique, appropriate patient selection is crucial. Long-term data are currently awaited on robotic parathyroidectomy especially in view of its high cost and long operative time compared to targeted parathyroidectomy and other minimally invasive techniques. At present, robotic parathyroidectomy can only be justified in patients who are predisposed to keloid or hypertrophic scarring or have cultural considerations leading to the desire to avoid a neck scar.

Keywords

Targeted parathyroidectomy Robotic parathyroidectomy Robot-assisted Remote access Transaxillary Axillary Retroauricular 

Supplementary material

Video Clip 26.1

Robotic transaxillary parathyroidectomy of a left inferior parathyroid adenoma (M4V 184345 kb)

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Copyright information

© Springer International Publishing Switzerland 2017

Authors and Affiliations

  1. 1.Division of Head and Neck Endocrine Surgery, Department of Otolaryngology—Head and Neck Endocrine SurgeryJohns Hopkins University School of MedicineBaltimoreUSA
  2. 2.Division of Endocrine Surgery, Department of SurgeryTulane University School of MedicineNew OrleansUSA

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