Fiducial distance for proper amplified endoscopic imaging of parathyroid gland by image 1 HID system / 中华内分泌外科杂志

ABSTRACT

objective To determine a proper fiducial photography distance setting for ideal amptitied endoscopic imaging of parathyroid gland by high definition endoscopy system.Methods 30 patients were operated with MIVAT mode (modified Miccoli's approach) for treatment of thyroid carcinoma from Apr.2013 to Mar.2014.High definition imaging was established by Image 1 Endoscopy System(Karl Storz Co.) to observe parathyroid gland and related fine anatomical structures during surgery.5 fiducial photography distances (1.0/1.5/2.0/2.5/3.0 cm) were separately tested during surgery.Maximally amplified parathyroid gland images of each setting were obtained by the approaching-amplifying photographic method,and then the size of the real parathyroid glands as well as their screen images were measured and recorded to calculate the magnification.A proper fiducial photography distance setting was determined postoperatively by comparison of the magnification times,as well as clarity,stability of the imaging and surgical maneuverability.Results ①90 parathyroid glands were successfully observed and measured.②At the longest fiducial photography distance (3.0 cm),the parathyroid gland could be stably magnified by 14.26±3.06(long trail)/12.62±2.88 (wide trail)times,but their contour and color not clear.③At the intermediate distance (2.5 cm),the parathyroid gland could be magnified by 16.74±3.15 (long trail)/14.81± 3.47(wide trail)times with the graphics stable,and the color and contour more clear,but the vascular pedicle and the tiny vessels under the capsule still blurred.④At the shortest distance (1.0 cm),the parathyroid gland could be magnified by 27.72±6.45 (long trail)/26.33±7.22(wide trail)times,not only the color and contour,but also the vascular pedicle and the tiny vessels under the capsule of the gland became further clearer,unfortunately the graphics was shimmy and unstable.Conclusions ①2.5 cm can be a proper fiducial photography distance for searching,identifying and preserving parathyroid gland in MIVAT,while 1.0 cm can be a special fiducial photography distance for further confirming parathyroid gland when necessary.② Current high definition endoscopy system can be applied to identify the parathyroid gland if fiducial photography distance was properly set and approachingamplifying photographic method was used.Along with the magnification of the imaging,the features of the parathyroid gland may become clearer,including its yellow-brown color and oval contour,as well as the detail structures such as the tiny vessels under the capsule and the vascular pedicle.