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Abstract
Twenty-five percent of primary hyperparathyroidism is caused by ectopic mediastinal
parathyroid glands, with 2% of these not accessible to standard cervical surgical
approaches. Advancement in video-assisted thoracoscopic surgical techniques has decreased
the need for sternotomy to successfully remove these ectopic glands. The thoracoscopic
approach, however, is limited by the surgeon's inability to always accurately visualize
ectopic glands. Intraoperative radionuclide-guided dissection, using a thoracoscopic
approach, provides a novel adjunct to the removal of occult ectopic parathyroid glands.
We report a case of an occult ectopic parathyroid adenoma removed thoracoscopically
using an intraoperative handheld gamma probe.