BackgroundWith the increasingly widespread use of endoscopic and robotic surgery as intelligent and precise forms of minimally invasive surgery in parathyroid surgery, and in response to the lack of uniform guidelines for their clinical practice, this expert consensus has been formulated with the aim of promoting the standardized implementation and promotion of endoscopic and robotic parathyroid surgery.MethodsBased on the latest literature and multicenter clinical experience, the expert group on thyroid surgery of the College of Surgeons of the Chinese Medical Association, the Thyroid Disease Specialty Committee of the Chinese Association of Research Hospitals and the Parathyroid and Bone Metabolism Disease Specialty Committee of the Chinese Association of Research Hospitals, the recommendations were formulated by a thorough discussion and multiple rounds of voting, and were ultimately developed This consensus (2025 edition).ResultsThis consensus systematically describes the indications and contraindications for endoscopic and robotic parathyroid surgery (especially primary hyperparathyroidism PHPT, secondary SHPT, and tertiary THPT), preoperative evaluation and preparation (whole-body assessment, stereotactic approach, and equipment selection), surgical equipment and instruments, operator qualification and training, choice of surgical access (robotic: BABA, non-inflatable The key contents include axillary approach, transoral vestibular approach; endoscopic: neck, chest and breast, transoral, etc.), key points of surgical operation and perioperative management, and prevention and treatment of complications.At 14 (3) months post-revision, patients with abnormal DeMeester scores had higher rates of patient satisfaction (82.9 vs. 65.5%, p = 0.026) and freedom from PPIs (77.6 vs. 60.3%, p = 0.037) with lower GERD-HRQL total scores [7.0 (2.0-21.5) vs. 14.0 (6.0-32.0), p = 0.003]. Abnormal DeMeester score was the strongest predictor of favorable outcomes after revisional ARS [OR 3.98 (1.75-9.04), p = 0.001].ResultsThis consensus systematically describes the indications and contraindications for endoscopic and robotic parathyroid surgery (especially primary hyperparathyroidism PHPT, secondary SHPT, and tertiary THPT), preoperative evaluation and preparation (whole-body assessment, stereotactic approach, and equipment selection), surgical equipment and instruments, operator qualification and training, choice of surgical access (robotic: BABA, non-inflatable The key contents include axillary approach, transoral vestibular approach; endoscopic: neck, chest and breast, transoral, etc.), key points of surgical operation and perioperative management, and prevention and treatment of complications.At 14 (3) months post-revision, patients with abnormal DeMeester scores had higher rates of patient satisfaction (82.9 vs. 65.5%, p = 0.026) and freedom from PPIs (77.6 vs. 60.3%, p = 0.037) with lower GERD-HRQL total scores [7.0 (2.0-21.5) vs. 14.0 (6.0-32.0), p = 0.003]. Abnormal DeMeester score was the strongest predictor of favorable outcomes after revisional ARS [OR 3.98 (1.75-9.04), p = 0.001].ConclusionThe Chinese Expert Consensus on Endoscopic and Robotic Parathyroid Surgery (2025 Edition) provides comprehensive guidance and reference for clinicians to standardize, safely and effectively perform endoscopic and robotic parathyroid surgery.