Complications - Heterotopic parathyroid autotransplantation in total parathyroidectomy - general and visceral surgery
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- Signal loss during IONM
- If this happens on the first side in a planned bilateral procedure, do not resect the contralateral side because otherwise this runs the risk of bilateral recurrent laryngeal nerve paralysis.
- Manage massive intraoperative hemorrhage (e.g., from the Kocher vein or inferior thyroid artery) first by packing, then identify the bleeder under continuous suction, clamp and ligate it.
- Missed parathyroids
- When no altered parathyroid tissue is found or glands are missing: Terminate the procedure and perform detailed diagnostic work-up