Future Directions in the Treatment of Thyroid and Parathyroid Disease

Endocrine surgery has made significant advances during the past several decades and continues to expand the surgical and nonsurgical techniques. Remote access thyroid and parathyroid surgery continues to push the boundaries of what can be done with the overall goal of improving the quality of patient care. Newer generation robotics are less cumbersome and easier to navigate in small cavities while attempting to recreate a sense of tactile feedback which is found in open surgery. The autofluor-escence technology for identifying parathyroid glands is promising for reducing the rate of temporary and perhaps permanent hypoparathyroidism. Quantifying autofluor-escence intraoperatively will likely become automated with AI whereby different emis-sion patterns will help differentiate between pathologic and normal parathyroid glands. More long-term data will emerge for various types of thermal ablation confirm-ing its oncological safety. Newer versions of the ablative techniques will incorporate recurrent nerve monitoring to ensure safety with higher temperatures. Future research will integrate AI to improve the workflow, safety, and diagnostic accuracy for preoper-ative assessment and intraoperative decision-making.