Robotic-assisted parathyroidectomy and short-term outcomes: a systematic review of the literature

J Robot Surg. 2020 Dec;14(6):821-827. doi: 10.1007/s11701-020-01119-x. Epub 2020 Jul 13.

Abstract

Minimal invasive techniques in endocrine surgery were lately adopted by surgical teams due to significant complications related to inadequate operative space and high risk of injuring crucial surrounding structures, such as vessels and nerves. Over the last years, technological improvements introduced robotic systems and approaches in endocrine surgery. Several case reports and series have described the safety and efficacy of these procedures such as robotic thyroidectomy and robotic parathyroidectomy. In the current review, we included 15 studies which described robotic-assisted parathyroidectomy for cervical parathyroid adenoma, in patients diagnosed with primary hyperparathyroidism or secondary hyperparathyroidism. No significant negative short-term outcomes were observed, in terms of postoperative complications, such as temporary or permanent injury of RLN, postoperative hypoparathyroidism and blood loss. The cosmetic result was, definitely, superior in comparison to conventional open parathyroidectomy. Despite the fact that RAP is an effective and curative method for patients with PHPT or secondary hyperparathyroidism, there are no available randomized clinical trials to establish this modern procedure as a gold-standard treatment strategy for these patients.

Keywords: Minimal invasive parathyroidectomy; Parathyroidectomy; Primary hyperparathyroidism; Robotic assisted; Transaxillary; Transoral.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Adenoma / surgery*
  • Female
  • Humans
  • Hyperparathyroidism, Primary / surgery*
  • Hyperparathyroidism, Secondary / surgery*
  • Male
  • Parathyroid Neoplasms / surgery*
  • Parathyroidectomy / methods*
  • Robotic Surgical Procedures / methods*
  • Treatment Outcome