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Parathyroid Function Saving Total Thyroidectomy Using Autofluorescence and Quantified Indocyanine Green Angiography.

Milou E Noltes^1,2, Madelon J H Metman¹, Liesbeth Jansen¹

¹Department of Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.

Videoendocrinology

|June 28, 2021

Summary

This study introduces a systematic method for total thyroidectomy using autofluorescence and indocyanine green (ICG) angiography to preserve parathyroid function. This approach aids in identifying parathyroid glands, preventing hypoparathyroidism after surgery.

Keywords:

ICG angiography autofluorescence hypoparathyroidism parathyroid total thyroidectomy

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Area of Science:

Surgical Oncology
Endocrinology
Medical Imaging

Background:

Postoperative hypoparathyroidism is a frequent complication following total thyroidectomy.
Techniques like autofluorescence and indocyanine green (ICG) angiography are increasingly used to preserve parathyroid glands during surgery.

Purpose of the Study:

To present a systematic, step-by-step approach for total thyroidectomy that utilizes autofluorescence and quantified ICG angiography to preserve parathyroid function.
To demonstrate a standardized workflow for employing these imaging techniques in thyroid cancer surgery.

Main Methods:

A systematic surgical approach for total thyroidectomy is detailed, incorporating parathyroid autofluorescence and quantified ICG angiography.
Specifics on camera settings, deployment timing, and a standardized workflow are provided.
The video demonstrates the technique in the context of thyroid cancer surgery.

Main Results:

The systematic approach facilitates early identification of parathyroid glands during total thyroidectomy.
This method aids surgeons in determining the need for parathyroid autotransplantation.
The technique aims to predict and prevent postoperative hypoparathyroidism.

Conclusions:

A systematic application of parathyroid autofluorescence and quantified ICG angiography during total thyroidectomy can enhance parathyroid gland identification.
This approach may lead to reduced rates of postoperative hypoparathyroidism.
The described method offers a standardized workflow for surgeons to improve parathyroid preservation outcomes.