PMC3461774_01
Schematic representation of GVAT; the surgical field is created by retractors (a) and surgery is performed by the view from the telescope (b)
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F1
A tent-like operative space was thus created and maintained by means of external retraction using small right-angled retractors and no gas insufflation was utilized [Figure 1].
The superior pedicle seen under magnification (a) and secured with sutures (b)
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F2
The dissection was directed to the superior pedicle which was secured and divided between 3-0 absorbable sutures [Figure 2].
(a) Endoscopic view of dissection in the lateral compartment. (b) The endoscope provides a magnified view of the parathyroids (white arrows)
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F3
The lateral compartment was then exposed and the blunt dissection was carried out separating the loose areolar tissue until the superior and inferior parathyroids could be easily identified [Figure 3].
The recurrent laryngeal nerve (white arrows) is seen during dissection (a) and after removal of the gland (b)
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F4
The recurrent laryngeal nerve was also easily identified at this stage and protected [Figure 4].