Abstract Aim Transanal total mesorectal excision is a promising novel sphincter‐saving procedure for low rectal cancer. However, the transanal bottom‐up dissection is associated with increased rates of iatrogenic urethral injuries. Near‐infrared fluorescence (NIRF) imaging, given its deeper tissue penetration, has been explored in a limited number of studies for enhanced intra‐operative urethral visualization. In this study, we explored the feasibility of a novel, ultrabright, biocompatible fluorescent polymer to coat urinary catheters for the purpose of intra‐operative urethral visualization. Methods In an ex vivo experiment, using a near‐infrared laparoscope, the fluorescent signal of a coated catheter (near‐infrared coating of equipment, NICE) was qualitatively and quantitatively compared to the signal of indocyanine green (ICG)/Instillagel® mixtures and ICG‐filled catheters at several concentrations. Also, in three male human torsos, using fluorescent urinary catheters, NIRF‐guided perineal dissections and a transanal total mesorectal excision were performed. ...
Abstract Introduction Current methods of intraoperative margin assessment in breast conserving surgery are impractical, unreliable, or time consuming. We hypothesized that intraoperative near-infrared (NIR) imaging with an FDA-approved NIR optical contrast agent could identify canine mammary tumors, a spontaneous large animal model of human breast cancer, during surgery. Methods Dogs with mammary tumors underwent a standard of care lumpectomy or mastectomy with wide surgical margins 20 hours after indocyanine green administration (3 mg/kg IV). During surgery, NIR imaging was performed on tumors and wound margins in situ and tumors and lymph nodes ex vivo. Following resection, the wound bed was examined for residual fluorescence. Fluorescence intensity was determined by signal-to-background ratio (SBR). All tumors, areas of residual fluorescence, and lymph nodes underwent histopathologic analysis. Results There were 41 mammary tumors in 16 female dogs. Twenty tumors were malignant and 21 ...
Question Can an intraoperative near-infrared fluorescence imaging technique be used to detect lung tumor margin via inhalation delivery of indocyanine green? Findings In this diagnostic study, the fluorescent signal of inhaled indocyanine green was observed throughout healthy lung tissue but was rarely detected in tumor tissue. Inhalation at a 20-fold lower dose of indocyanine green had a 2-fold higher efficiency for tumor margin detection compared with the intravenous injection of indocyanine green. Meaning Image-guided surgery based on low-dose indocyanine green inhalation appears to facilitate rapid, long-term visualization of the tumor margin of lung tumors.
The incidence of primary non-function (PNF) after liver transplantation (LT) remains a major concern with the increasing use of marginal grafts. Indocyanine green (ICG) fluorescence is an imaging technique used in hepatobiliary surgery and LT. Because few early predictors are available, we aimed to quantify in real time the fluorescence of grafts during LT to predict their 3 months survival.
Pratik Kanabur, MD1; Christy Chai, MD2,3; Jennifer Taylor, MD, MPH1,3
To evaluate the efficacy of indocyanine‐green (ICG) fluorescence angiography (FA) in reducing the incidence of anastomotic leak (AL) following colorectal anastomoses.
Introduction: Surgery is the most important therapy for patients with cancer of the colon, rectum or pancreas. Complete resection, which is a crucial factor in the prognosis of a patient, is challenging as surgeons have to rely on visual appearance and palpation to discriminate between tumor and normal tissue. Carcinoembryonic antigen (CEA) is a tumor-specific marker that is highly expressed in a number of tumors of epithelial origin (such as colorectal carcinoma and pancreas carcinoma) while it is minimally expressed in normal adult tissues. The compound that will be studied in this research project is SGM-101, a CEA-specific chimeric antibody conjugated with a near-infrared (NIR) emitting moiety. The hypothesis is that, following preoperative iv administration of SGM-101 in patients with carcinoma of the colon, rectum or pancreas, SGM-101 will bind to CEA expressing cancer cells and these cells can ...
Anastomotic leakage (AL) is one of the most troublesome complications in colorectal surgery.
Fluorescent antibody SGM-101
Fluorescence-guided surgery (FGS) provides surgeons with new opportunities to improve real-time cancer nodule detection and tumor margin visualization.