Excision of solitary parathyroid adenoma

  1. Skin incision

    Skin incision

    Incise the skin 2 finger widths (2-3 cm) superior to the suprasternal notch between the bellies of the left and right sternocleidomastoid muscles (so-called Kocher or collar incision). Divide the platysma with electrocautery.

    Note: In single parathyroid adenomas with well-known location the skin incision may be much smaller than, e.g., in thyroidectomy.

  2. Subcutaneous dissection, midline division

    Subcutaneous dissection, midline division

    Divide the subcutaneous tissue and enter the white line of the neck. Between forceps divide and ligate any superficial jugular veins in the cervical fascia.

    Tip: Simple ligatures of the cervical veins often slip off during surgery. Closure is best accomplished by suture-ligation (PDS 3/0).

  3. Exposing the thyroid

    Exposing the thyroid

    Retract the strap muscles of the neck from the anterior aspect of the thyroid. Expose both thyroid lobes circumferentially, expose the trachea and divide any superficial vessels encountered.

Locating the parathyroid adenoma

At first, no tumor can be palpated on the right side. For better view, first expose the superior po

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