Endoscopic Parathyroidectomy for Ectopic Primary Hyperparathyroidism A Minimally Invasive Procedure for Urolithiasis Patient

Aim: Open parathyroidectomy with a neck incision is a well-established procedure, but the scar in the neck usually causes a mental burden especially for female patients. We introduce a form of endoscopic surgery without neck or anterior incision, resulting in a great cosmetic advantage for primary hyperparathyroidism (PHPT) with urinary calculi. Methods: We treated 4 PHPT patients with urolithiasis between September 2000 and September 2001. Preoperative imaging studies showed presumed solitary ectopic adenoma. Endoscopic parathy- roidectomy was performed via a precordial approach using 3 trocar ports. Results: The operation time was not different between endoscopic and open surgery. The amount of blood loss during endoscopic surgery was less than 30 ml. We achieved satisfactory results in terms of cosmetic as well as endocrinological viewpoints. Conclusions: Endoscopic parathyroidectomy is feasible for PHPT with solitary adenoma, especially for female patients.