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01-07-2017

Intraoperative localization of the parathyroid glands with indocyanine green and Firefly(R) technology during BABA robotic thyroidectomy

Authors: Hyeong Won Yu, Joon Woo Chung, Jin Wook Yi, Ra-Yeong Song, Joon-Hyop Lee, Hyungju Kwon, Su-jin Kim, Young Jun Chai, June Young Choi, Kyu Eun Lee

Published in: Surgical Endoscopy | Issue 7/2017

Abstract

Background

It is unclear whether near-infrared (NIR) light-induced indocyanine green (ICG) fluorescence can effectively identify, and thus permit the preservation of, parathyroid glands in bilateral axillo-breast approach (BABA) robotic thyroidectomy. This case–control study with a prospectively recruited consecutive series and a retrospectively selected control group assessed the usefulness of ICG with Firefly(R) technology to identify the parathyroid glands intraoperatively during BABA robotic thyroidectomy.

Methods

All consecutive patients (N = 22) who were scheduled to undergo BABA robotic thyroidectomy for papillary thyroid carcinoma in December 2013–August 2015 and met the study eligibility criteria were recruited prospectively. ICG fluorescence was used with the Firefly system (NIR illuminator: 805 nm; filter: 825 nm) integrated in the da Vinci Si robot system to identify the lower parathyroid glands. Parathyroid hormone levels were recorded on postoperative days 0, 1, 2, and 14. Propensity score matching was used to identify an age-, gender-, tumor size-, and operation type-matched group of control patients who underwent BABA robotic thyroidectomy without the Firefly system. The two groups were compared in terms of parathyroid-related outcomes.

Results

ICG fluorescence-mediated identification of the parathyroid and thyroid glands required on average (range) 203 ± 89 (125–331) and 207 ± 112 (130–356) s, respectively. The mean (range) fluorescence duration in these glands was 20.8 ± 6.0 (16.6–35.8) and 20.1 ± 7.3 (15.5–33.8) min, respectively. The ICG group had a significantly lower rate of incidental parathyroidectomy than the control group (0 vs. 15.9%, P = 0.048).

Conclusions

ICG with NIR light may feasibly and safely identify the parathyroid glands in BABA robotic thyroidectomy.

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Title: Intraoperative localization of the parathyroid glands with indocyanine green and Firefly(R) technology during BABA robotic thyroidectomy
Authors: Hyeong Won Yu
Joon Woo Chung
Jin Wook Yi
Ra-Yeong Song
Joon-Hyop Lee
Hyungju Kwon
Su-jin Kim
Young Jun Chai
June Young Choi
Kyu Eun Lee
Publication date: 01-07-2017
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 7/2017
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-016-5330-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Intraoperative localization of the parathyroid glands with indocyanine green and Firefly(R) technology during BABA robotic thyroidectomy

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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