ABSTRACT
The surgical management of primary hyperparathyroidism (HPT) has evolved from open neck exploration to minimally invasive surgery since the first successful parathyroidectomy was performed by Felix Mandl in Vienna in 1925. Minimally invasive parathyroidectomy (MIP) is now the treatment of choice for patients with sporadic HPT, with a parathyroid tumour localized by pre-operative imaging. This chapter describes the indications and technique of MIP in the management of sporadic primary HPT. The most important aspect in the use of minimally invasive parathyroid surgery is to establish the correct diagnosis and localize the disease accurately. The indications for MIP are no different from the conventional cervical exploration – symptomatic or asymptomatic patients fulfilling the established National Institutes of Health criteria. The superior adenoma is usually located in an area above the intersection of the inferior thyroid artery with the recurrent laryngeal nerve, posteriorly in the retropharyngeal or in the retro-oesophageal space.
