Fluorescence Applications in Parathyroid Surgery
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Indocyanine green (ICG) fluorescence angiography can be used to quickly and accurately localize parathyroid glands during parathyroid and thyroid surgery with minimal risk. Because the technique relies on an intact vascular pedicle, it can also be used to assess parathyroid gland perfusion, which can be used as a surrogate for postoperative parathyroid gland function. Several commercially available near-infrared imaging systems can be used for this technique, and their adoption for a wide array of indications has grown in recent years. ICG fluorescence angiography should be considered as an adjunctive method for parathyroid localization during parathyroid surgery.
KeywordsFluorescence-guided surgery Indocyanine green Primary hyperparathyroidism
The video demonstrates ICG fluorescence angiography in four different cases. The first case uses a laparoscope capable of fluorescence imaging. The second uses a different laparoscope capable of fluorescence imaging. The third uses a handheld camera device with improved ergonomics for open uses of fluorescence angiography. And the fourth case shows an example of two parathyroid glands identified in the same field (MP4 430688 kb)
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