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Monthly publications

#November 2007
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Minimally invasive video-assisted right parathyroidectomy for hyperparathyroidism
This video demonstrates a minimally invasive approach to excision of a parathyroid adenoma. A mini-incision is placed transversely in the midline and the laparoscope provides a magnified image for dissection. Modified instruments from open surgery are used and all the parathyroid glands can potentially be accessed by this approach.
This is the case of a 48-year-old female patient who has complained for several years of bone and muscular pain. Systematic preoperative diagnostic work-up showed hypercalcemia (3.5 mmol/L), hypophosphatemia (0.70 mol/L) and increased PTH levels (180 picograms/mL).
A superior right parathyroid adenoma was suspected on cervical ultrasound.
A CT-scan was performed preoperatively and a superior left parathyroid adenoma was found.
MIBI scintigraphy evidenced an area of increased uptake consistent with this.
A 2 cm suprasternal incision is carried out and the left lateral thyroid lobe is approached. The inferior thyroid artery and the left recurrent nerve are identified. These two structures are the major landmarks to correctly identify the parathyroid adenoma, which is then completely dissected before the pedicle is ligated.
M Vix, J Marescaux
Surgical intervention
10 years ago
350 views
23 likes
0 comments
08:48
Minimally invasive video-assisted right parathyroidectomy for hyperparathyroidism
This video demonstrates a minimally invasive approach to excision of a parathyroid adenoma. A mini-incision is placed transversely in the midline and the laparoscope provides a magnified image for dissection. Modified instruments from open surgery are used and all the parathyroid glands can potentially be accessed by this approach.
This is the case of a 48-year-old female patient who has complained for several years of bone and muscular pain. Systematic preoperative diagnostic work-up showed hypercalcemia (3.5 mmol/L), hypophosphatemia (0.70 mol/L) and increased PTH levels (180 picograms/mL).
A superior right parathyroid adenoma was suspected on cervical ultrasound.
A CT-scan was performed preoperatively and a superior left parathyroid adenoma was found.
MIBI scintigraphy evidenced an area of increased uptake consistent with this.
A 2 cm suprasternal incision is carried out and the left lateral thyroid lobe is approached. The inferior thyroid artery and the left recurrent nerve are identified. These two structures are the major landmarks to correctly identify the parathyroid adenoma, which is then completely dissected before the pedicle is ligated.
Lights on NOTES, October 12, 2007
This recording of a masterclass in NOTES held at the IRCAD (2nd International NOTES hands-On Course, October 12-13, 2007) demonstrates the salient steps of several NOTES operations performed simultaneously and includes the comments of a live audience and input from expert observers. The 'PEG' method of obtaining access to the peritoneum via a gastrotomy is shown in a stepwise manner as well as more advanced transluminal procedures such as cholecystectomy, nephrectomy, distal pancreatectomy and sigmoidectomy. All operations are performed by pioneers in this specialist field from around the world and so this video record presents an exceptional opportunity to witness a state-of-the-art workshop.
Surgical intervention
10 years ago
11130 views
7 likes
0 comments
02:17
Lights on NOTES, October 12, 2007
This recording of a masterclass in NOTES held at the IRCAD (2nd International NOTES hands-On Course, October 12-13, 2007) demonstrates the salient steps of several NOTES operations performed simultaneously and includes the comments of a live audience and input from expert observers. The 'PEG' method of obtaining access to the peritoneum via a gastrotomy is shown in a stepwise manner as well as more advanced transluminal procedures such as cholecystectomy, nephrectomy, distal pancreatectomy and sigmoidectomy. All operations are performed by pioneers in this specialist field from around the world and so this video record presents an exceptional opportunity to witness a state-of-the-art workshop.