Is it wise to attempt to reduce exploration in patients with primary hyperparathyroidism, or would it be better to explore all 4 glands in every case? This is a central question in the treatment of hyperparathyroidism today because new technology, including preoperative imaging, intraoperative radioguided nuclear mapping, and intraoperative parathyroid hormone monitoring, may help identify cases of single adenoma in which limited exploration would be satisfactory. Ideally, if the 87% of patients with a single adenoma in our series could be identified reliably, we could perform 1-gland exploration and reserve bilateral 4-gland exploration for patients who have multigland disease and/or coexisting thyroid pathologic features. Perceived benefits of reduced exploration include a smaller incision with better cosmesis, no likelihood of permanent hypoparathyroidism, and decreases in anesthesia, operative trauma, operative time, hospitalization, pain, and overall expense. Patients are gratified to have a 40-minute operation, walk away that same day with a bandaid on a small incision, and enjoy a meal at home that evening with their family. The 1-gland "bandaid" operation appeals to patients and referring physicians, but it does so at a cost; currently, we are unable to ensure that all of the unexplored glands are normal. In our series, we limited the exploration to 1 gland or 1 side in 124 patients (67%) with 6 failures (5%) due to undisclosed abnormal parathyroid glands in areas intentionally not explored, all of whom required reoperation to achieve eucalcemia.