Benefits and risks

Information for the public

The evidence that NICE looked at for video‑assisted keyhole surgery to remove abnormal parathyroid glands showed that the procedure was safe enough and worked well enough to be used on the NHS for this condition.

The 8 studies that NICE looked at involved a total of about 1180 patients treated by video‑assisted keyhole surgery.

Generally, they showed the following benefits:

97‑100% of patients with hyperparathyroidism were cured
5‑14% of patients who started having video‑assisted keyhole surgery had to change to have open surgery
similar or better cosmetic results than open surgery
less or similar amounts of pain than with open surgery.

The studies showed that the risks included:

paralysis of 1 vocal cord in 3% of patients, which can affect ability to speak clearly or loudly and causing breathlessness, which got better within 3 months
temporary or permanent damage to a nerve going to the voice box, each in 1% of patients, which can cause changes such as difficulty in speaking or swallowing
bleeding after the operation in 1 patient, who needed more surgery
low levels of calcium in the blood in 3–13% of patients, which caused symptoms in some and, in 2 patients, needed treatment with vitamin D.

If you want to know more about the studies, see the guidance. Ask your health professional to explain anything you don't understand.