Feasibility and Efficacy of Indocyanine Green Angiography in Transoral Robotic Thyroidectomy: A Pilot Study

ABSTRACT Background This study aimed to evaluate the feasibility and effectiveness of indocyanine green (ICG) angiography in transoral robotic thyroidectomy (TORT). Methods A total of 130 patients with papillary thyroid carcinoma who underwent TORT with ICG angiography (ICG group, 65 patients) and without ICG angiography (control group, 65 patients) were analyzed. Results The parathyroid detection rate did not differ between the control and ICG groups. Among patients with total thyroidectomy, the incidence of postoperative transient hypoparathyroidism did not differ between the control (7/20, 35%) and ICG (4/20, 20%) groups. Pearson's correlation coefficients between the total ICG perfusion score and postoperative changes in serum intact parathyroid hormone and calcium levels showed statistical significance. Conclusions ICG angiography is feasible in TORT. Although it did not improve the parathyroid detection rate or reduce the incidence of hypoparathyroidism, ICG angiography was able to predict postoperative parathyroid function, as assessed by the total ICG perfusion score.