Scoping review of approaches used for remote-access parathyroidectomy: A contemporary review of techniques, tools, pros and cons

Yoshiyuki Saito; Yoshifumi Ikeda; Hiroshi Takami; Amr H Abdelhamid Ahmed; Atsushi Nakao; Hiroshi Katoh; Keiso Ho; Masato Tomita; Michio Sato; Neil S Tolley; Gregory W Randolph

doi:10.1002/hed.27068

Scoping review of approaches used for remote-access parathyroidectomy: A contemporary review of techniques, tools, pros and cons

Head Neck. 2022 Aug;44(8):1976-1990. doi: 10.1002/hed.27068. Epub 2022 Apr 25.

Authors

Yoshiyuki Saito^{1

2

3}, Yoshifumi Ikeda⁴, Hiroshi Takami⁵, Amr H Abdelhamid Ahmed¹, Atsushi Nakao⁶, Hiroshi Katoh⁷, Keiso Ho², Masato Tomita², Michio Sato², Neil S Tolley⁸, Gregory W Randolph^{1

9}

Affiliations

¹ Division of Thyroid and Parathyroid Endocrine Surgery, Department of Otolaryngology - Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA.
² Department of Surgery, International Goodwill Hospital, Yokohama, Japan.
³ Department of Surgery, Keio University School of Medicine, Tokyo, Japan.
⁴ Department of Surgery, International University of Health and Welfare, Atami Hospital, Atami, Japan.
⁵ Department of Surgery, Ito Hospital, Tokyo, Japan.
⁶ Department of Surgery Gastroenterology Center, International University of Health and Welfare, Mita Hospital, Tokyo, Japan.
⁷ Department of Surgery, Kitasato University School of Medicine, Sagamihara, Japan.
⁸ Imperial College Healthcare NHS Trust, London, UK.
⁹ Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.

PMID: 35467046
DOI: 10.1002/hed.27068

Abstract

After our coauthors described the first remote-access parathyroidectomy (RAP) series in 2000, several other approaches were developed. No systematic review has been performed to classify and evaluate RAP techniques. We performed a literature search using PubMed and Cochrane Library (CENTRAL). A total of 71 studies met our inclusion/exclusion criteria. RAP can be categorized into five approaches: (1) endoscopic and robotic axillary, (2) anterior chest, (3) transoral, (4) retroauricular, and (5) a combination of these approaches. The limited data in the literature suggest that the cure rates and safety of RAP are in no way inferior to those of open parathyroidectomy. Each approach has its advantages and disadvantages, and the recommendations for the selection of each approach are listed. The selection of approach methods might depend on the surgeon's experience and familiarity and the patient's preference and disease status.

Keywords: endoscopic parathyroidectomy; hyperparathyroidism; minimally invasive parathyroidectomy; remote access; robot-assisted parathyroidectomy.

Publication types

Review

MeSH terms

Axilla
Endoscopy
Humans
Minimally Invasive Surgical Procedures / methods
Parathyroidectomy* / methods
Robotics*