Various minimally invasive techniques exist for surgical parathyroidectomy. The aim of this study was to conduct a meta-analysis comparing two popular minimally-invasive techniques: Video Assisted Minimally Invasive Parathyroidectomy (MIVAP) and Open Minimally-Invasive Parathyroidectomy (OMIP).

An extensive search was conducted of online databases to identify all previous studies which had compared MIVAP and OMIP. The primary outcome measures considered were VAS pain score 24 hours postoperatively, conversion of operation (to open), failure rate and analgesic consumption. The data from these studies was extracted and compiled into a meta-analysis.

The literature search yielded 104 studies of which 4 were included, enrolling 903 patients in this analysis. A significant difference was found regarding rates of conversion to open parathyroidectomy between the two groups, with the OMIP group demonstrating fewer conversions (MD= 3.52, CI= (2.04- 6.08), P< 0.00001). No statistically significant differences were found between the two groups when comparing VAS score post-op 24hrs (MD= -1.75, CI= (-9.8 - 6.3) P= 0.67), consumption of analgesia (OR= 0.49, CI= 0.07- 3.54, P=0.48) or failure rates (OR= 1.81, CI= 0.58- 5.72, P= 0.31).

OMIP was seen to require less need to conversion to open parathyroidectomy with shorter operative times, while similar complication rates and scar lengths to MIVAP. More studies are required to evaluate the superior technique for parathyroidectomy.