Preoperative Parathyroid Imaging for the Endocrine Surgeon

Over the past decade, minimally invasive directed parathyroidectomy (DP) has become the operation of choice for most patients with sporadic primary hyperparathyroidism (PHPT). Using preoperative imaging as a tool to guide the operation, DP has many advantages over the traditional four-gland exploration. Positive scans were present in about 80% of patients. This minimally invasive approach may be performed under local anesthesia, requires less operative time, results in decreased postoperative pain, and offers improved aesthetics [1, 2]. The DP approach has the added advantage of earlier hospital discharge and a decrease in the overall associated costs for the procedure.