INTRAOPERATIVE FLUORESCENCE IMAGING:
A PRECISE AND EFFICIENT METHOD.
Parathyroid gland identification can be challenging even for skilled surgeons due to their tiny size (a few mm) and that they are often buried in fat tissue or ectopic (located in atypical areas).
The unexpected excision of healthy parathyroid glands is a current complication of thyroidectomies. This can lead to hypoparathyroidism, most of the time transient, and might come with disruptions of calcium metabolism and notably hypocalcemia. It is therefore critical to properly identify parathyroid glands during surgery.
the most powerful parathyroid imaging solution!
FLUOBEAM® LX is an imaging device exclusively dedicated to thyroid and parathyroid surgery, which offers surgeons with an optimal comfort of use throughout the procedure. Highly sensitive, it allows to detect parathyroid gland by autofluorescence with an optimized real-time display, a high depth of field and a compatibility with ambient operating room lights.
See FLUOBEAM® LX
in operating room.
FLUOBEAM® LX IN ACTION
Parathyroid gland identification
Parathyroid glands naturally emit fluorescence in the near Infrared without any dye injection. This is called autofluorescence. FLUOBEAM® LX allows the surgeon to identify in real-time parathyroid glands and to preserve them during surgery.
FLUOBEAM® LX also allows surgeons to visualize parathyroid adenoma using autofluorescence. This detection guides the surgeon and makes resection easier.
Identification of vessels that vascularize parathyroid glands
By easily combining autofluorescence and indocyanine green angiography during the procedure, FLUOBEAM® LX allows a clear identification of vessels that vascularize parathyroid glands and their preservation during thyroid dissection.
The global information provided by FLUOBEAM® LX (localization and vascularization of parathyroid glands) should allow to decrease significantly postoperative complications linked to damaged parathyroid glands during surgery.
Checking the parathyroid gland vascularization
It is commonly known that complications such as transient hypocalcemia are linked to the unexpected excision of parathyroid glands or the alteration of the vascularization of these glands during thyroid surgery.
After intravenous injection of indocyanine green, FLUOBEAM® LX allows surgeons to clearly visualize the vascularization of the parathyroid glands and therefore to assess their viability during the surgery.
Prof. Frédéric Triponez shares his experience on fluorescence imaging.
University Hospital of Geneva - Switzerland
Dr Fernando Dip
Maxillofacial surgery, otolaryngologists, University of Buenos Aires, Argentina and Cleveland Clinic, Florida, USA
'NIR fluorescence imaging significantly increases the number of parathyroid glands identified during thyroid surgery.'
Dr. Sam Van Slycke
Endocrine Surgeon, OLV Clinic Aalst, Belgium.
'Near infrared (autofluorescence) imaging in endocrine surgery is a helpful tool in confirming and visualization of parathyroid glands. It is an excellent teaching instrument for less experienced surgeons. In combination with ICG fluorescence it can change your intra-operative decision making!'
> Dip F, and al. A Randomized, Controlled Trial Comparing White-Light with Near-Infrared Autofluorescence for Parathyroid Gland Identification during Total Thyroidectomy. Journal of the American College of Surgeons. 2019 Jan 30. pii: S1072-7515(19)30081-X.
> Moore EC, and al. Near-infrared imaging in re-operative parathyroid surgery: first description of autofluorescence from cryopreserved parathyroid glands. Gland Surgery 2018 Dec 11.
> Kose E and al. Heterogeneous and low-intensity parathyroid autofluorescence: Patterns suggesting hyperfunction at parathyroid exploration. Surgery. 2018 Sep 28.
> Kahramangil B, and al. Detection of Parathyroid Autofluorescence Using Near-Infrared Imaging: A Multicenter Analysis of Concordance Between Different Surgeons. Ann Surg Oncol. 2018 Feb 6.
> Kahramangil B. and Berber E. Comparison of indocyanine green fluorescence and parathyroid autofluorescence imaging in the identification of parathyroid glands during thyroidectomy. Gland Surg. 2017 Dec6(6):644-648.
> Benmiloud F. Impact of autofluorescence-based identification of parathyroids during total thyroidectomy on postoperative hypocalcemia: a before and after controlled study. Surgery 2017
> Kahramangil B. and Berber E. The use of near-infrared fluorescence imaging in endocrine surgical procedures. J. Surg. Oncol. 2017
> Falco J. and al. Increased identification of parathyroid glands using near infrared light during thyroid and parathyroid surgery. Surg Endosc. 2017
> De Leeuw F. and al. Intraoperative Near-infrared Imaging for Parathyroid Gland Identification by Auto-fluorescence: A Feasibility Study. World Journal of Surgery – 2016 Sep;40(9):2131-8.