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Safe thyroidectomy with intraoperative methylene blue spraying.

Serkan Sari1, Erhan Aysan, Mahmut Muslumanoglu

  • 1Deparment General Surgery, Bezmialem Vakif University, Faculty of Medicine, Vatan Caddesi, Fatih, Istanbul, Turkey. dr@webcerrah.com.

Thyroid Research
|November 15, 2012
PubMed
Summary

Methylene blue spraying during thyroid surgery effectively identifies critical structures. This technique aids in distinguishing parathyroid glands, recurrent laryngeal nerves, and thyroid arteries, minimizing operative complications.

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Area of Science:

  • Surgical Innovation
  • Endocrine Surgery
  • Medical Imaging Agents

Background:

  • Minimizing operative complications in thyroid surgery is a key goal.
  • Methylene blue stain can be used to visualize tissues during surgery.

Purpose of the Study:

  • To evaluate the effectiveness of a novel methylene blue spraying technique for intraoperative identification of critical structures during thyroid surgery.
  • To assess the safety and efficacy of this spraying technique in minimizing operative complications.

Main Methods:

  • A prospective study involving 56 patients undergoing bilateral total thyroidectomy.
  • Intraoperative spraying of 0.5ml methylene blue onto the thyroid lobe and perilober area after superior pole ligation.
  • Evaluation of the identification and staining characteristics of parathyroid glands, recurrent laryngeal nerves, and inferior thyroid arteries.

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Main Results:

  • Recurrent laryngeal nerves and arteries remained unstained (white), while surrounding tissues stained blue.
  • Parathyroid glands regained their original color within three minutes.
  • Thyroid tissue, muscles, and other structures showed sustained staining for longer durations.

Conclusions:

  • The methylene blue spraying technique is effective for intraoperative identification of parathyroid glands, recurrent laryngeal nerves, and inferior thyroid arteries.
  • This method enhances surgical safety by clearly delineating critical structures, thereby reducing operative complications.
  • The technique offers a valuable adjunct to standard surgical procedures for thyroid disease.