TOETVA parathyroid autofluorescence detection: hANDY-i endoscopy attachment

Area of Science:

• Endocrinology
• Surgical Innovation
• Medical Imaging

Background:

• Transoral endoscopic thyroidectomy vestibular approach (TOETVA) offers scarless thyroid pathology treatment.
• Standardized methods for parathyroid gland (PG) localization during TOETVA are lacking, increasing risks of injury and hypocalcemia.
• This study introduces an endoscopic attachment for improved PG detection in TOETVA.

Purpose of the Study:

• To evaluate the feasibility of the hANDY-i endoscopic attachment for detecting parathyroid glands during transoral thyroidectomy.
• To assess the hANDY-i system's ability to visualize PGs in conjunction with TOETVA.

Main Methods:

• A prototype parathyroid autofluorescence imager (hANDY-i) was attached to a 10-mm 0-degree endoscope.
• The hANDY-i device provided a split-screen view of Red-green-blue (RGB) and near-infrared autofluorescence (NIRAF).
• Simultaneous anatomical and fluorescence visualization of PGs was enabled during endoscopic thyroid dissection.

Main Results:

• The hANDY-i system was tested in one cadaveric and two patient cases.
• Parathyroid glands (PGs) were successfully visualized using the endoscopic hANDY-i imaging system in all procedures.

Conclusions:

• Utilizing parathyroid autofluorescence with the hANDY-i system may enhance PG localization and preservation during TOETVA.
• Further clinical trials are necessary to determine the impact on postoperative hypocalcemia and hypoparathyroidism.