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Minimally Invasive Parathyroidectomy (MIP)

Advanced endocrine surgical technique to remove a preoperatively localized parathyroid adenoma through a small incision.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Genel Cerrahi department. Book Appointment →

What is Minimally Invasive Parathyroidectomy (MIP)?

Minimally invasive parathyroidectomy (MIP) is the technique of removing a single parathyroid adenoma that has been preoperatively localized through imaging via a 2-3 cm lateral approach incision. It was developed as an alternative to traditional bilateral four-gland exploration.

Preoperative localization is critical for the success of the procedure. When sestamibi scintigraphy (with single-photon emission tomography, SPECT) and neck ultrasound give concordant results, MIP can be applied. In case of discordance, 4D-CT or selective venous sampling can be used.

Intraoperative PTH (iPTH) monitoring is performed during surgery. A drop of more than 50% from baseline value of PTH within 10 minutes after adenoma removal and a return to normal range is defined as the 'Miami criteria' and indicates curative resection. Hospital stay is short, and many patients can be discharged as day-case surgery.

Symptoms

Primary hyperparathyroidism
Localizable single adenoma
Symptomatic hypercalcemia
Nephrolithiasis and impaired renal function
Osteoporosis and pathologic fracture
Positive parathyroid preoperative localization
Young active patient (cosmetic)

Risk Factors

Multiple adenomas or hyperplasia (insufficient resection)
Non-localized parathyroid
MEN syndromes
Familial hyperparathyroidism
Previous neck surgery
Concomitant Hashimoto thyroiditis
Secondary or tertiary hyperparathyroidism

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Hypercalcemia and high PTH
  • History of kidney stones
  • Osteoporotic fracture
  • Fatigue, depression, muscle weakness
  • Parathyroid endocrine evaluation
  • Multidisciplinary parathyroid council

Treatment Methods

01
Preoperative sestamibi scintigraphy and neck US
02
4D-CT (when needed)
03
Local or general anesthesia
04
2-3 cm focused incision
05
Lateral exploration of the adenoma
06
Intraoperative PTH monitoring (Miami criteria)
07
Postoperative calcium and vitamin D follow-up

Which Department to Visit?

You can visit our Genel Cerrahi department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.