THYROID AND PARATHYROID DISEASES: DIAGNOSIS, TREATMENT AND SURGERY WITH CURRENT APPROACHES

thyroid_and_parathyroid_diseasesnevinsakoglukapak1-0-25

THYROID AND PARATHYROID SURGERY

Yasemin Yıldırım

Memorial şişli Hospital, Department of General Surgery, İstanbul, Türkiye

Yasemin Y. Thyroid and Parathyroid Surgery. Kesici U, ed. Thyroid and Parathyroid Diseases: Diagnosis, Treatment and Surgery with Current Approaches. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.103-118.

ABSTRACT

Primary hyperparathyroidism (pHPT) is commonly treated with parathyroidectomy (PTx), with mini- mally invasive techniques (MIP) offering effective alternatives. MIP reduces complications and recov- ery time. Open MIP is widely performed due to its relatively easy learning curve. However, endoscopic and robotic PTx are more complex, and there is still no consensus regarding their standardization. By measuring PTH levels during surgery, IOPTH helps ensure the adequacy of PTx, minimize unneces- sary exploration, and predict surgical success. Minimally invasive thyroidectomy (MIT) offers reduced scarring and faster recovery but comes with challenges and potential complications. The choice of ap- proach depends on patient factors and the desired surgical outcome. Recurrent laryngeal nerve (RLN) injury is a common complication of thyroidectomy. While visual identification remains standard, in- traoperative nerve monitoring (RLNM) provides feedback, especially in challenging surgeries. RLNM does not significantly reduce nerve injury rates but can aid in preserving nerve function.

Keywords: Minimally invasive surgical procedures; Parathyroid hormone; Recurrent laryngeal nerve

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