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Case report| Volume 142, ISSUE 3, P410-413, September 2007

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Intercostal Video-Assisted Mediastinal Surgery through an intercostal window (IVAMS): A simpler approach to perform mediastinal parathyroidectomy

      Although ectopic parathyroid adenomas have been reported to occur in 4 to 25% of patients with hyperparathyroidism,
      • Peeler B.B.
      • Martin W.H.
      • Sandler M.P.
      • et al.
      Sestamibi parathyroid scanning and preoperative localization studies for patients with recurrent/persistent hyperparathyroidism or significant comorbid conditions: development of an optimal localization strategy.
      • Vail A.D.
      • Coller F.C.
      The parathyroid glands: clinicopathologic correlation of parathyroid disease as found in 200 unselected autopsies.
      • Phitayakorn R.
      • McHenry C.R.
      Incidence and location of ectopic abnormal parathyroid glands.
      • Cupisti K.
      • Dotzenrath C.
      • Simon D.
      • Röher H.D.
      • Goretzki P.E.
      Therapy of suspected intrathoracic parathyroid adenomas Experiences using open transthoracic approach and video-assisted thoracoscopic surgery.
      most of these adenomas can be excised through standard cervical approach. Thoracic parathyroid ectopia is an uncommon situation causing persistent or recurrent hyperparathyroidism.
      • Sitges-Serra A.
      • Sancho J.J.
      • Pereira J.A.
      • Girvent M.
      • Pascual M.
      • Berna L.
      Hiperparatiroidismos debidos a glándulas paratiroides de localización ectópica.
      Minimally invasive techniques have been developed as an alternative to sternotomy or lateral thoracotomy.
      • Russell C.F.
      • Edis A.J.
      • Scholz D.A.
      • Sheedy P.F.
      • van Heerden J.A.
      Mediastinal parathyroid tumors: experience with 38 tumors requiring mediastinostomy for removal.
      • Norton J.A.
      • Schneider P.D.
      • Brennan M.F.
      Median sternotomy in reoperations for primary hyperparathyroidism.
      • Wang C.
      • Gaz R.D.
      • Moncure A.C.
      Mediastinal parathyroid exploration: a clinical and pathologic study of 47 cases.
      We present a new approach to perform ectopic parathyroidectomy consisting of an Intercostal Video-Assisted Mediastinal Surgery through a unique intercostal window (IVAMS); it was developed as an alternative to standard Video-Assisted Thoracic Surgery (VATS) in order to simplify, if possible, the management of these infrequent operative cases.
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