Surgical treatment of primary hyperparathyroidism.

OBJECTIVE

To review the surgical treatment options for primary hyperparathyroidism with a focus on recent refinements in minimally invasive techniques and endoscopic and video- or robot-assisted parathyroidectomy.

METHODS

We review the relevant surgical treatment options for primary hyperparathyroidism.

RESULTS

Parathyroidectomy is the standard therapy for patients with primary hyperparathyroidism. Advancements in imaging, including technetium Tc 99m-sestamibi single-photon emission computed tomography and ultrasonography, have improved preoperative localization, while intraoperative parathyroid hormone measurement provides a rapid test to confirm operative success. These adjuncts have enabled surgeons to perform an operation that is both safe and minimally invasive.

CONCLUSIONS

The minimally invasive approach to parathyroidectomy provides comparable cure rates to conventional bilateral neck exploration with reduced operative time and improved cosmetic results. The durability, safety, and success of these procedures make them valuable options in the current and future care of patients with primary hyperparathyroidism.