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ApplicationsApplication fieldsGeneral surgeryAutofluorescence of the parathyroid glands

Autofluorescence imaging of the parathyroid glands


Various complications can arise during thyroid surgery: possible complications include injury to the vocal cord nerves or damage to the function of the parathyroid glands.

Early detection is important to minimise the risk of injury of the parathyroid glands.

The parathyroid glands have autofluorescent properties, which means that they can easily be visualised using autofluorescence imaging. This technology supports surgeons during thyroid dissection and enables a clearer demarcation from surrounding tissue.

Reduction of transcient hypocalcaemia

Several clinical teams have demonstrated that the use of autofluorescence in thyroid surgery leads to better preservation of the parathyroid glands and their functions, which can significantly reduce the rate of transient post­operative hypocalcaemia.[1] [2]

Preservation of the parathyroid glands 
On average, pathologists find that a parathyroid gland is accidentally removed in 6.4% to 31.1% of thyroidectomies and is found in the removed specimen. With the help of autofluorescence, these parathyroid glands can be more easily identified during surgery and, in most cases, preserved.[3] [4]

More reimplantations are possible
Autofluorescence can be combined with fluorescence imaging by injection of indocyanine green (ICG). This enables precise identification of the para­thyroid glands and their supplying vessels during surgical interventions, thus reducing the risk of unintentional devascularisation. The FLUOBEAM® LX, which combines autofluorescence and ICG fluorescence imaging in real time, shows both the location and blood flow of the parathyroid glands.

In cases where the parathyroid glands are not preserved, they can be localised in the removed specimen using autofluorescence imaging. This enables fast reimplantation.[5] [6]

FLUOBEAM LX® – The solution for imaging the parathyroid glands

The FLUOBEAM® LX is the first FDA-approved and CE-certified imaging system for parathyroid autofluorescence in para­thyroid surgery. The precise camera solution for parathyroid surgery enables identification of the parathyroid glands based on their autofluorescence. With the help of ICG, the FLUOBEAM® LX can also visualise the vascularisation of the parathyroid glands. Easy handling and optimised ergonomics in the form of a joystick make it easier for the surgeons to navigate and select the software functions. Thanks to a sterile camera cover, the surgeons have control over the use of the technology at all times and can also document images and videos independently. During its use, the FLUOBEAM® LX also demonstrates reduced sensitivity to disturbing light from the light sources in the operating theatre. This enables real-time visualisation of the parathyroid glands even without switching off the operating light completely. The operating flow remains largely unaffected. The powerful imaging software creates optimal working conditions for the FLUOBEAM® LX in the field of thyroid surgery and enables easy interpretation of the images.

Relevant products for the application field

FLUOBEAM® LX INTEGRATED SOLUTION
FLUOBEAM® LX INTEGRATED SOLUTION
CS_FBLX_IS
FLUOBEAM® LX INTEGRATED SOLUTION
Includes camera system, panel PC and trolley with holder and various storage options
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FLUOBEAM® LX COMPLEMENTARY SOLUTION
FLUOBEAM® LX COMPLEMENTARY SOLUTION
CS_FBLX_PC_A
FLUOBEAM® LX COMPLEMENTARY SOLUTION
Includes camera system, holder for the camera and panel PC with base
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Relevant accessories for the application field

Carrying case for FLUOBEAM® LX
Carrying case for FLUOBEAM® LX
FX-LX
Carrying case for FLUOBEAM® LX
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Holder for FLUOBEAM® LX optical head
Holder for FLUOBEAM® LX optical head
LXHO
Holder for FLUOBEAM® LX optical head
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Disposable - Sterile cover dedicated to clinical FLUOBEAM® LX
Disposable - Sterile cover dedicated to clinical FLUOBEAM® LX
ADD-031
Disposable - Sterile cover dedicated to clinical FLUOBEAM® LX
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References

  1. Di Lorenzo, S. et al. (2024). Impact of near-infrared fluorescence imaging plus indocyanine green fluorescence on postoperative hypoparathyroidism rates after total thyroidectomy and central neck lymph node dissection. The British journal of surgery, 111(2), znae022.
  2. Benmiloud, F. et al. (2020). 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 surgery, 155(2), 106–112.
  3. Wolf, H. W. et al. (2022). Near-infrared autofluorescence of the parathyroid glands during thyroidectomy for the prevention of hypoparathyroidism: a prospective randomized clinical trial. Langenbeck's archives of surgery, 407(7), 3031–3038.
  4. Serra, C., Silveira, L., & Canudo, A. (2020). Identification of inadvertently removed parathyroid glands during thyroid surgery using autofluorescence. Gland surgery, 9(4), 893–898.
  5. Karampinis, I. et al. (2018). Intraoperative Indocyaningrün-Fluoreszenzbildgebung zur Sicherung vitaler Nebenschilddrüsen bei Schilddrüsenresektionen. Zentralblatt fur Chirurgie, 143(4), 380–384.
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