**1. Introduction**

Prof. Richard Owen firstly identified the parathyroid gland in an Indian rhinoceros in 1850 [1]. Ivar V. Sandström also found this gland in humans and firstly named it as "glandulae parathyroidae" in 1887 [1]. Because Gley observed that animals whose parathyroid glands were removed subsequently developed tetany in the 1890s, the parathyroid gland and their function became widely appreciated [2]. After that, surgeons understood that the parathyroid glands were vital organs to be treated cautiously during thyroidectomy.

© 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. © 2018 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Hypoparathyroidism is the most common and a potentially serious complication of thyroid surgery, which can lead to metabolic and physiologic disturbance, prolonged hospitalization and medical supplementation [3–6]. In general, the prevalence of transient and permanent hypoparathyroidism is reported to range from 14–60% and 4–11%, respectively [7]. Total thyroidectomy (TT) with central neck dissection (CND) significantly increases the rate of transient and permanent hypoparathyroidism in comparison with total thyroidectomy.

In this chapter, a new operation concept, "a layer of thymus-blood vessel-inferior parathyroid gland (TBP)," is mainly introduced to preserve the inferior parathyroid gland (IPTG) *in situ* during CND for papillary thyroid carcinoma (PTC).
