TOETVA parathyroid autofluorescence detection: hANDY-i endoscopy attachment.
TOETVA parathyroid autofluorescence detection: hANDY-i endoscopy attachment.
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DOI：
10.3389/fendo.2023.1233956
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发表时间：
2023
影响因子：
5.2
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中科院分区：
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甲状腺病变的治疗选择已经扩展到包括无瘢痕和远程访问方法，如经口内镜甲状腺切除术前庭方法（TOETVA）。目前，还没有标准化的方法来定位接受TOETVA的患者的甲状旁腺（PG），这可能导致甲状旁腺损伤和随后的低钙血症。该早期可行性研究描述并评价了hANDY-i内窥镜附件在经口甲状腺切除术中检测PG的情况。我们使用了一个原型甲状旁腺自体荧光成像仪（hANDY-i），安装到一个10毫米0度内窥镜。该设备提供红绿蓝（RGB）和近红外自体荧光（NIRAF）的分屏视图，允许在内窥镜甲状腺剥离术期间同时进行PG的解剖定位和荧光可视化。本研究包括1例尸体病例和2例患者病例。内窥镜hANDY-i成像系统在所有手术过程中成功可视化PG。TOETVA期间利用甲状旁腺自体荧光的能力可能会改善PG定位和保存。需要进一步的人体研究来评估其对术后低钙血症和甲状旁腺功能减退的影响。
Treatment options for thyroid pathologies have expanded to include scarless and remote access methods such as the transoral endoscopic thyroidectomy vestibular approach (TOETVA). Currently, no standardized methods exist for locating parathyroid glands (PGs) in patients undergoing TOETVA, which can lead to parathyroid injury and subsequent hypocalcemia. This early feasibility study describes and evaluates the hANDY-i endoscopic attachment for detecting PGs in transoral thyroidectomy. We used a prototype parathyroid autofluorescence imager (hANDY-i) that was mounted to a 10-mm 0-degree endoscope. The device delivers a split screen view of Red-green-blue (RGB) and near-infrared autofluorescence (NIRAF) which allows for simultaneous anatomical localization and fluorescence visualization of PGs during endoscopic thyroid dissection. One cadaveric case and two patient cases were included in this study. The endoscopic hANDY-i imaging system successfully visualized PGs during all procedures. The ability to leverage parathyroid autofluorescence during TOETVA may lead to improved PG localization and preservation. Further human studies are needed to assess its effect on postoperative hypocalcemia and hypoparathyroidism.