Bilateral parathyroid exploration for hyperparathyroidism

In recent years, there has been considerable interest in unilateral parathyroid surgery with the goals of achieving high cure rates of hyperparathyroidism but accomplishing this with perhaps shorter operative times, fewer complications, and better cosmesis than associated with traditional bilateral exploration. Although limited parathyroid exploration has had demonstrated success in selected patients, clear indications still exist for evaluating all 4 parathyroids by bilateral neck exploration. This article describes our technique and the pre- and intraoperative contexts warranting bilateral parathyroid exploration.