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Experience gained from 100 patients with surgically and histologically proven primary hyperparathyroidism over a period of 14 years led to simplification of diagnostic procedures and development of a surgical scheme. Over the years patients with discrete disease symptoms or with asymptomatic disease were observed more frequently. This can be seen as the result of earlier diagnosis due to increasing spread of laboratory autoanalysers and the resulting routine calcium determination. Development of surgical intervention is characterised by omitting preoperative diagnostic procedures to determine localisation, a schematised operation, and more reliance on macroscopic criteria rather than on quick sections during surgery.