Indocyanine green fluorescence-guided redo parathyroidectomy.
Re-operative neck surgery for hyperparathyroidism is a technically difficult operation that requires adjunctive studies to assist with finding the parathyroid tissues. Intraoperative tests help minimise exploration of the neck and decrease injuries to the surrounding structures. Indocyanine green is a near-infrared fluorescent dye that in pre-clinical models was found to be useful in locating the parathyroid glands of dogs. No study has yet reported its use as a tool for parathyroid localisation in humans. We investigated the use of indocyanine green to assist with localisation of a recurrent parathyroid adenoma using a near-infrared imaging system. After exposure of the neck tissues, the parathyroid gland fluoresced brightly and directed our dissection. Exploration of the neck was minimal, and allowed for fast localisation and excision of the adenoma. Overall, use of indocyanine green is a simple and safe technique of intraoperative parathyroid localisation that warrants further investigation.
Department of Surgery, University of California, San Diego, La Jolla, California, USA.
Jeffery M
JM
Chakedis
Department of Surgery, UCSF Fresno Medical Education Program, Fresno, California, USA.
Christina
C
Maser
Department of Surgery, University of California, San Diego, La Jolla, California, USA.
Kevin T
KT
Brumund
Department of Surgery, University of California, San Diego, La Jolla, California, USA.
Michael
M
Bouvet
D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D006961:Hyperparathyroidism / Q000000981:diagnostic imaging / Q000601:surgery*; D007208:Indocyanine Green; D061848:Optical Imaging / Q000379:methods; D016105:Parathyroidectomy / Q000379:methods*; D012086:Reoperation; D025321:Surgery, Computer-Assisted; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D007208:Indocyanine Green