Eugene Oh1,2, Hun Chan Lee3, Yoseph Kim1, Bo Ning2, Seung Yup Lee4,5, Jaepyeong Cha2,6, Wan Wook Kim7. 1. Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland, USA. 2. Sheikh Zayed Surgical Institute, Children's National Hospital, Washington, District of Columbia, USA. 3. Department of Mechanical Engineering, Boston University, Boston, Massachusetts, USA. 4. Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia, USA. 5. Department of Electrical and Computer Engineering, Kennesaw State University, Marietta, Georgia, USA. 6. Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA. 7. Department of Surgery, Kyungpook National University Chilgok Hospital, Daegu, South Korea.
Abstract
OBJECTIVES: Intraoperative localization and preservation of parathyroid glands (PGs) are challenging during thyroid surgery. A new noninvasive technique of combined near-infrared PG autofluorescence detection and dye-free imaging angiography that allows intraoperative feedback has recently been introduced. The objective of this study was to evaluate this technique in real-time. MATERIALS AND METHODS: A pilot feasibility study of a portable imaging device in four patients who underwent either thyroid lobectomy or total thyroidectomy is presented. PG autofluorescence and vascularity/tissue perfusion were monitored using a real-time screen display during the surgical procedure. RESULTS: Three lobectomies and one total thyroidectomy were performed. Among the nine PGs identified by the operating surgeon, eight PGs were confirmed using the autofluorescence device. Each PG was successfully determined to be either well-perfused or devascularized, and devascularized PGs were autotransplanted. CONCLUSIONS: The preliminary results suggest that the combination of PG autofluorescence detection and dye-free angiography can potentially be used to assess PG function. With further validation studies, the effectiveness of this technique in clinical practice can be further delineated.
OBJECTIVES: Intraoperative localization and preservation of parathyroid glands (PGs) are challenging during thyroid surgery. A new noninvasive technique of combined near-infrared PG autofluorescence detection and dye-free imaging angiography that allows intraoperative feedback has recently been introduced. The objective of this study was to evaluate this technique in real-time. MATERIALS AND METHODS: A pilot feasibility study of a portable imaging device in four patients who underwent either thyroid lobectomy or total thyroidectomy is presented. PG autofluorescence and vascularity/tissue perfusion were monitored using a real-time screen display during the surgical procedure. RESULTS: Three lobectomies and one total thyroidectomy were performed. Among the nine PGs identified by the operating surgeon, eight PGs were confirmed using the autofluorescence device. Each PG was successfully determined to be either well-perfused or devascularized, and devascularized PGs were autotransplanted. CONCLUSIONS: The preliminary results suggest that the combination of PG autofluorescence detection and dye-free angiography can potentially be used to assess PG function. With further validation studies, the effectiveness of this technique in clinical practice can be further delineated.
Authors: Emin Kose; Anatoliy V Rudin; Bora Kahramangil; Edwina Moore; Husnu Aydin; Mustafa Donmez; Vikram Krishnamurthy; Allan Siperstein; Eren Berber Journal: Surgery Date: 2019-09-13 Impact factor: 3.982
Authors: Giju Thomas; Carmen C Solórzano; Naira Baregamian; Emmanuel A Mannoh; Rekha Gautam; Rebecca T Irlmeier; Fei Ye; Jon A Nelson; Samuel E Long; Paul G Gauger; Alexa Magner; Tyler Metcalf; Lawrence A Shirley; John E Phay; Anita Mahadevan-Jansen Journal: Am J Surg Date: 2021-05-13 Impact factor: 2.565