Clinical Challenges in Endocrine Surgery: Autofluorescence in Endocrine Surgery

Behind The Knife: The Surgery Podcast

Science, Health & Fitness, Medicine, Education

4.8 • 1.4K Ratings

🗓️ 23 November 2023

⏱️ 33 minutes

🔗️ Recording | iTunes | RSS

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Summary

Making a discovery that changes how we practice is one of the most exciting things about the fields of medicine and surgery. In this episode, join endocrine surgeons Drs. Barb Miller, John Phay, Priya Dedhia, and Surgical Oncology Fellow Dr. Samantha Ruff from The Ohio State University. Hear Dr. Phay tell the story of how parathyroid autofluorescence was discovered and the work that has gone on since that day. The group discusses several articles focusing on intraoperative adjuncts used to identify parathyroid tissue during thyroid and parathyroid surgery.

Hosts: Barbra S. Miller, MD (Moderator), Clinical Professor of Surgery, John Phay, MD, Clinical Professor of Surgery, Priya H. Dedhia, MD, PhD, Assistant Professor of Surgery, Samantha Ruff, MD, Surgical Oncology Fellow, Division of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.

Twitter handles:
Barbra Miller - @OSUEndosurgBSM
John Phay – @JohnPhayMD
Priya Dedhia – @priyaknows
Samantha Ruff - @SamRuff_MD

Learning objectives:
1) Understand the background of the discovery of parathyroid autofluorescence
2) Describe various intraoperative adjuncts utilized to identify parathyroid tissue
3) Compare and contrast the advantages and disadvantages of using autofluorescence versus indocyanine green for identification of parathyroid tissue
4) Recognize the impact of use of intraoperative imaging adjuncts on postoperative hypocalcemia (short and long-term)
5) Understand the general safety issues for the parathyroid imaging techniques discussed

References:
1. Benmiloud, F., G. Godiris-Petit, R. Gras, et al., Association of Autofluorescence-Based Detection of the Parathyroid Glands During Total Thyroidectomy With Postoperative Hypocalcemia Risk: Results of the PARAFLUO Multicenter Randomized Clinical Trial. JAMA Surg, 2020. 155(2): p. 106-12 DOI: 10.1001/jamasurg.2019.4613. https://pubmed.ncbi.nlm.nih.gov/31693081/

2. Kahramangil, B. and E. Berber, Comparison of indocyanine green fluorescence and parathyroid autofluorescence imaging in the identification of parathyroid glands during thyroidectomy. Gland Surg, 2017. 6(6): p. 644-8 DOI: 10.21037/gs.2017.09.04. https://pubmed.ncbi.nlm.nih.gov/29302480/

3. Paras, C., M. Keller, L. White, et al., Near-infrared autofluorescence for the detection of parathyroid glands. J Biomed Opt, 2011. 16(6): p. 067012 DOI: 10.1117/1.3583571. https://pubmed.ncbi.nlm.nih.gov/21721833/

4. Vidal Fortuny, J., V. Belfontali, S.M. Sadowski, et al., Parathyroid gland angiography with indocyanine green fluorescence to predict parathyroid function after thyroid surgery. Br J Surg, 2016. 103(5): p. 537-43 DOI: 10.1002/bjs.10101. https://pubmed.ncbi.nlm.nih.gov/26864909/

Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

If you liked this episode, check out other Behind the Knife endocrine episodes: https://behindtheknife.org/podcast-category/endocrine/

Transcript

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0:00.0	Behind the surgery podcast, relevant and engaging content designed to help you dominate the day.
0:13.0	Ladies and gentlemen, I am thrilled to introduce the third edition of the Behind the
0:28.8	Knife Absight Podcast Companion.
0:32.1	This latest version offers enhanced images with immersive audio content for each
0:36.7	section, making it an unparalleled educational resource. We've expanded our content with new chapters covering topics like MIS,
0:46.2	oncology, OBGYN, urology, and more.
0:51.2	You can find the book in both print and e-book formats on Amazon.
0:54.3	Get ready to elevate your knowledge and achieve top Ab site scores with the all new
0:59.2	Behind the Knife Absight Podcast Companion, an indispensable partner on your path to surgical excellence.
1:05.1	Good luck on the upcoming Absight exam and dominate the day.
1:08.8	Welcome to another Anukran Surgery Podcast.
1:11.8	I'm Barb Miller from the Ohio State University
1:14.0	and I'll be your moderator today. I'll be joined a day by the rest of our endocrine surgeons
1:18.1	here at OSU, Dr. John Fay, clinical professor of surgery and Dr Priededia, assistant professor of surgery and Dr. Priedadia, assistant professor of surgery.
1:24.4	Also joining us is Dr. Samantha Ruff,
1:26.4	one of our current second year surgical oncology fellows.
1:29.7	Today's topic is the use of fluorescent adjuncts
1:32.3	in thyroid and parathyroid surgery.
1:34.0	Given that the identification of parathyroid glands can be difficult for even the most
1:38.0	experienced parathyroidist and in an effort to minimize persistent post-operative hypotherroidism or hypocalcemia,
1:45.0	there's been a surge in interest in investigation over the past decade of intraoperative adjuncts
1:49.5	utilized to identify parathiraglains during thyroid and parathirid surgery.
	...

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