- Bleeding
- Manage massive intraoperative hemorrhage (e.g., from the Kocher vein or inferior thyroid artery) first by packing, then identify the bleeder under continuous suction, clamp and ligate it.
- Adenoma not identified or inadequate drop in IOPTH level from baseline.
- No altered parathyroids found or no parathyroids found at all→bilateral exploration→extended cervical exploration→ termination of procedure and extended diagnostic work-up.