[Operative technique in primary hyperparathyroidism].

The aim of surgical intervention in the treatment of primary hyperparathyroidism (pHPT) is the achievement of normocalcemia and euparathyreosis. Despite improved diagnostic procedures containing comparatively modified pre- and intraoperative methods to determine the position of the parathyroid glands and the most efficient operative technique including minimal-invasive surgery thereof, success cannot be guaranteed. Therefore, we should strive to avoid reintervention by ensuring a hemorrhage-free, atraumatic, anatomical-orientated operation and providing positive preconditions for reoperation. Success is based on the four pillars of the HPT surgery: history, embryology with anatomy, neck surgery and experience. By means of this principle and the results of surgical treatment in 1634 patients with pHPT from 1982 until 1998, we demonstrate a standardized operative technique of pHPT.