Primary hyperparathyroidism in adults—(Part II) surgical management and postoperative follow‐up: Position statement of the Endocrine Society of Australia, The Australian & New Zealand Endocrine Surgeons, and The Australian & New Zealand Bone and Mineral Society

Diagnostic imaging does not determine suitability for surgery but can guide surgical planning in suitable candidates

First-line imaging: US and either parathyroid 4DCT or scintigraphy, depending on local availability and expertise

Minimally invasive parathyroidectomy is appropriate in most patients with concordant imaging

Consider bilateral neck exploration with discordant/negative imaging, multi-gland disease and genetic/familial risk factors

Parathyroid surgery, especially re-operative, has better outcomes with higher volume surgeons

Neuromonitoring generally not required for initial surgery but should be considered for re-operative surgery

After parathyroidectomy, re-check calcium and PTH in the first 24 h; repeat early if risk factors for hypocalcaemia

Eucalcaemia at 6 months is consistent with surgical cure; PTH need not be re-checked absent other clinical indications

Longer-term surveillance of skeletal health is recommended