Rabin Medical Center parathyroidectomy protocol
Since 2010, our protocol at Rabin medical center for parathyroidectomies
is as follows: localization of a parathyroid adenoma is performed for
all patients using two imaging modalities: Sestamibi and US. If both
imaging modalities are concordant, confirmation of adenoma resection
during surgery is performed with frozen section, without the use of
IOPTH monitoring. We do use IOPTH monitoring during parathyroidectomy in
any other clinical scenario, such as: pre-operative imaging is not
concordant; double adenoma; parathyroid hyperplasia; secondary or
tertiary hyperparathyroidism; patients with a diagnosis of MEN1 or
MEN2A; revision surgery.