Fluorescence imaging–guided robotic thyroidectomy and central lymph node dissection

Background: The purpose of this study was to evaluate the feasibility of complete central compartment node dissection (CCND) using fluorescence imaging (FI) during robotic thyroidectomy. Methods: A total of 110 patients underwent robotic thyroidectomy and CCND from August 2015 to June 2016; 55 patients underwent robotic surgery using FI (FI group) and the other 55 patients without it (control group). The FI group was injected with indocyanine green into the thyroid to enhance the identification of lymph nodes (LNs). Results: Indocyanine green–stained LNs were easily detected using FI. The number of harvested LNs was 7.0 in the FI group and 4.8 in the control group (P = 0.004). There was lower rate of transient hypocalcemia in the FI group (18.5%) than control group (26.7%), but there was no significant difference (P = 0.417). There were no other significant differences between the two groups. Conclusions: The use of FI during robotic thyroidectomy facilitated the identification of LNs and guided complete CCND.