Recently we have seen some remarkable changes in the way that we approach the patient who has primary hyperparathyroidism. Although not all concur, many surgeons now believe that as a result of several technological advances, minimally invasive parathyroidectomy is the preferred approach for such patients.1 These advances include preoperative localization with technetium Tc 99m sestamibi scanning, high-resolution ultrasonography, the availability of intraoperative parathyroid hormone level monitoring, and intraoperative nuclear mapping via the use of the handheld gamma-detection device. Interestingly, all were relatively unheard of (or declared not useful) just a decade ago!
Ross AJ. Radioguidance Is Not Necessary During Parathyroidectomy—Invited Critique. Arch Surg. 2002;137(8):970. doi:10.1001/archsurg.137.8.970