Recent trends becoming standard of care yielding smaller, more successful operations at a lower cost

Surgeons are now performing much smaller, more directed parathyroid operations in less time, and reported cure rates are the highest they have ever been. The ability to operate physiologically,and not just anatomically, has allowed a more directed and confident approach. This approach has subsequently led to minimal use of anesthesia and to immediate postoperative discharge,changes that have been embraced enthusiastically by referring endocrinologists. This article discusses the intraoperative monitoring used by the author and the pitfalls that can await the inexperienced surgeon.