Auto-Transplantation of a Parathyroid Gland

  • The auto-transplantation site is directed by the pathological condition directing bilateral neck exploration (BNE):
    • As a general rule of thumb:
      • If the devascularized gland is morphologically normal:
        • It is transplanted into the sternocleidomastoid muscle
      • If the devascularized gland is morphologically abnormal:
        • The gland is transplanted into a site remote from the operative field:
          • Such as the brachioradialis muscle
Procedure for auto-transplant into brachioradialis. These images demonstrate the steps taken to transplant an abnormal parathyroid gland into the right brachioradialis muscle of a patient with tertiary hyperparathyroidism. (a) A 2-cm incision is made over the brachioradialis muscle approximately 5 cm distal to the cubital crease. The dissection is continued down to the deep fascia, with care taken to identify and protect the posterior cutaneous nerve of the forearm (a). (b) The fascia is incised and a 1-cm pocket is created in the muscle. (c) The morcellated parathyroid tissue is placed into the pocket. (d) The fascia is closed, and the position of the auto-transplant is marked with a Hemoaclip at its proximal and distal extent, and a Prolene suture between these

#Arrangoiz #ParathyroidSurgeon #ParathyroidExpert #Parathyroidectomy #MSMC #MountSinaiMedicalCenter #HeadandNeckSurgeon #Surgeon #Teacher #EndocrineSurgery

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