Abstract: Objective To evaluate the feasibility using 3-dimentional (3D) virtual model in digital surgery design of trans-areola single-site endoscopic parathyroidectomy (TASSEP) based on principle of precise surgery. Methods A retrospective analysis was performed on the clinical data of 12 patients with primary hyperparathyroidism (PHPT) who received TASSEP from April 2017 to December 2018. All patients had preoperative localization with ultrathin CT scan to build 3D virtual models for precise surgical design. Parathyroid hormone and blood calcium were detected preoperatively and postoperatively. The complications were recorded after surgery. Cosmetic and biochemical results were followed up. Results TASSEP was completed in all 12 patients successfully according to the preoperative digital surgery without conversion to open surgery. No complication was present after surgery. The surgical time was (97.1±30.3) min with blood loss (18.7±2.8) mL and cosmetic satisfactory median score 8 (7-10). The parathyroid hormone and serum calcium levels were normal at 6 month postoperative follow-up without recurrence. Conclusions 3D virtual model for digital surgery design of PHPT would be used for safety and efficiency of surgery and cosmetic outcomes.

Key words: 3-dimentional digital technique, Single-site endoscopy, Parathyroid