Along with recurrent laryngeal nerve palsy, hypoparathyroidism is one of the procedure-specific complications of thyroidectomy. Safe identification and preservation of parathyroid glands can minimize this complication. Avoiding accidental removal of parathyroid glands with the surgical specimen must be one of the main goals. Parathyroid autofluorescence is a method for visualizing parathyroid glands.

In 2022 100 consecutive removed thyroid lobes were included in this study. In addition to the surgeon's meticulous inspection of the lobectomy specimen, all lobes were also examined for any attached parathyroid glands using an IR laser system from Fluoptics® (Grenoble, France) before the pathological examination. Identified parathyroid glands were subjected to autotransplantation; to confirm the diagnosis, all specimens were also histologically examined, as well as PE of the transplanted parathyroid gland.

In 34 cases of 100 lobectomy specimens, a parathyroid gland that had not previously been preserved in situ (e.g. far ventral position) or recognized was detected. In 28 cases these were recognized by both the surgeon and the IR laser system. In 6 cases, the IR laser system detected a gland that had not previously been visually identified by the surgeon (18%). In all cases histology confirmed parathyroid tissue.

The use of an IR laser system can reliably detect parathyroid glands in the site and on the surgical specimen. In the latter case, this reduces the rate of accidental removal of parathyroid glands.