{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T06:04:13Z","timestamp":1780639453705,"version":"3.54.1"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T00:00:00Z","timestamp":1780617600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Ectopic mediastinal parathyroid adenomas are a rare cause of persistent primary hyperparathyroidism and present operative challenges due to proximity to major mediastinal structures. Robotic trans-subxiphoid resection using multi-port platforms has been described; however, experience with a true uniportal single-port robotic approach remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We report a case series of two patients with biochemically confirmed primary hyperparathyroidism and imaging-localized anterior mediastinal parathyroid adenomas who underwent excision using a single-port subxiphoid robotic technique with the da Vinci SP system. Operative variables, intraoperative parathyroid hormone (PTH) response, perioperative outcomes, and pathology were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Single-port subxiphoid robotic excision was completed successfully in 100% (2\/2) of cases with no conversions and no intraoperative complications. Mean operative time was 150\u2005min (170 and 130\u2005min), and estimated blood loss was &amp;lt;50\u2005mL in both cases. Critical structures, including the innominate vein and bilateral phrenic nerves, were clearly visualized and preserved. Intraoperative PTH levels decreased by &amp;gt;80% at 10\u2005min post-excision in both patients, meeting Miami criteria. PTH decreased from 172\u2005pg\/mL to 22\u2005pg\/mL in one patient and from 296\u2005pg\/mL to 99\u2005pg\/mL, with subsequent normalization, in the other. Both patients were discharged on postoperative day one with normalization of ionized calcium at 1-week follow-up. Final pathology confirmed parathyroid adenoma in both cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This series demonstrates the safety and feasibility of a true uniportal single-port subxiphoid robotic approach for ectopic mediastinal parathyroid adenomas and highlights its potential as a highly minimally invasive alternative for selected patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2026.1830874","type":"journal-article","created":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T05:37:06Z","timestamp":1780637826000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Series: Single-port subxiphoid robotic excision of ectopic mediastinal parathyroid adenomas"],"prefix":"10.3389","volume":"13","author":[{"given":"Shayan","family":"Hosseinzadeh","sequence":"first","affiliation":[{"name":"Department of Surgery, University of Miami Hospital , Miami, FL","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Miami Hospital , Miami, FL","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahsa","family":"Shariat","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Miami Hospital , Miami, FL","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nestor","family":"Villamizar","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Miami Hospital , Miami, FL","place":["United 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