[Modern approach to parathyroidectomy].

Parathyroid surgery underwent significant innovations in the past 20 years, after both the improvement of the imaging techniques used to localize abnormal parathyroids (ultrasonography and MIBI scintiscan) and the possibility of the intraoperative PTH assay. These two tools, in experienced hands, can correctly differentiate uniglandular (more than 85% of the cases of primary hyperparathyroidism) from multiglandular disease. These technological improvements led to the possibility of limiting the surgical exploration to the single parathyroid responsible for the hyperparathyroidism in the majority of cases, avoiding unnecessary bilateral exploration that might increase both the morbidity of the surgery and its global costs.