Langenbeck's Archives of Surgery

, Volume 394, Issue 5, pp 799–809

Intraoperative adjuncts in surgery for primary hyperparathyroidism

Current Concepts in Endocrine Surgery



This paper is a review of the evidence base to produce recommendations for the use of intraoperative parathyroid hormone (PTH), radioguided parathyroidectomy (RGP), methylene blue (MB), frozen section, and intraoperative neuromonitoring during surgery for primary hyperparathyroidism (PHPT).

Materials and methods

A Medline keyword search of English-language articles led to the production of a draft document, subsequently revised by committee, containing levels of evidence and the grading of recommendations as proposed by the Agency for Healthcare Research and Quality.


Literature review provides the basis for clear recommendations on the use of intraoperative PTH at surgery for PHPT. There is little evidence to support the use of RGP, MB, routine frozen section, and intraoperative neuromonitoring.


Intraoperative PTH Radioguided parathyroidectomy Methylene blue Frozen section Intraoperative neuromonitoring Parathyroidectomy 

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  1. 1.Endocrine SurgeryRoyal Hallamshire HospitalSheffieldUK
  2. 2.Thoracic & Endocrine SurgeryUniversity Hospital of GenevaGenevaSwitzerland

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