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Minimally invasive video-assisted parathyroidectomy in dogs: Technique description and feasibility study.

OBJECTIVE
To describe a minimally invasive approach to the parathyroid gland for the treatment of primary hyperparathyroidism.


STUDY DESIGN
Surgical technique description and clinical case report.


ANIMALS
Five canine cadavers and 5 client-owned dogs with primary hyperparathyroidism.


METHODS
A surgical technique for minimally invasive video-assisted parathyroidectomy (MIVAP), described for humans, was adapted for dogs. With the dog in dorsal recumbency, a 15 mm incision was made on the midline, 1 finger width caudal to the cricoid cartilage of the larynx. A 5 mm 30° rigid endoscope was inserted into the peritracheal space with the aid of a blunt suction dissector, and fine elevators. The parathyroid was subsequently removed using electrocautery and blunt and sharp dissection. The technique was refined in 5 cadaver dogs to assess feasibility, and was subsequently performed in 5 clinical cases.


RESULTS
A minimally invasive approach to the parathyroid gland was possible and allowed successful removal of a parathyroid mass in 5 dogs without complication. The use of fluid ingress was trialed in 1 cadaver and not found to be helpful. The use of a blunt suction dissector greatly facilitated dissection of the peritracheal space.


CONCLUSION
Minimally invasive video-assisted parathyroidectomy is feasible in dogs and was not associated with complications in 5 clinical cases.


CLINICAL SIGNIFICANCE
Minimally invasive techniques tend to reduce morbidity and are popular with pet owners. This study demonstrates that a minimally invasive technique may be considered for parathyroidectomy in dogs.