The role of autofluorescence and Indocyanine green (ICG) in Endocrine Surgery

Parathyroid preservation during total thyroidectomy is crucial in preventing postoperative hypoparathyroidism. The use of intraoperative parathyroid hormone monitoring has been shown to reduce the incidence of hypoparathyroidism. However, this method has limitations, and alternative techniques such as autofluorescence and ICG angiography have emerged as potential options for parathyroid preservation. The use of ICG angiography and near-infrared autofluorescence has shown promise in improving parathyroid gland preservation and reducing the risk of postoperative hypocalcaemia and hypoparathyroidism. The combination of autofluorescence and ICG angiography has also been found to be useful in identifying parathyroid glands in challenging cases, such as reoperations for thyroid or parathyroid diseases. However, further studies are needed to establish its long-term safety and efficacy and to address the limitations of its implementation in clinical practice.