Radio-guided Minimally Invasive Parathyroidectomy: A Descriptive Report of the Experience from Tertiary Center

Sir,

We read with interest the article “Radioguided minimally invasive parathyroidectomy: A descriptive report of the experience from tertiary center in Bangalore” by Vidya et al.[1] We congratulate the authors on their experience of minimally invasive parathyroidectomy (MIP) using radio-guided technique. We also agree with the authors that radio-guided parathyroidectomy can abate the need for intraoperative parathyroid hormone (PTH) and if available can help the knife happy surgeons in performing MIP. The authors have performed this procedure with 2 cm incision, and we agree to the small incision in the definition of MIP, but in the Indian subcontinent, the mean size of these adenomas.[2]

We have a few queries of which may be of benefit to future readers. Did the authors use any other adjuncts in surgery like surgical loupe and frozen section biopsy? What was the mean size of their adenoma? What was the mean duration of surgery in which they did not use radio guided surgery and did it make a significant difference? Did they retract or divide the strap muscles? What was the timing of PTH postoperatively? In how much percentage of patients, the phenomenon of delayed calcium fall was exhibited?