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.