Bile duct injuries during laparoscopic cholecystectomy remain a potentially devastating complications and are responsible for major 1 morbidity and prolonged hospitalization . Visual misperception, anatomical variations in the extrahepatic biliary tree, combined with inflammatory changes and surgeon inexperience in recognizing the 2 anatomy, are among the most common reasons for these injuries . Near-infrared Incisionless Fluorescent Cholangiography (NIFC) has been shown to improve the visualization and identification of the biliary structures compared to traditional white light.
In spite of many technical advances, esophagectomy remains a morbid procedure. The most dreaded complication is the leakage at the esophagogastric anastomosis, often determined by the tenuous vascular perfusion of the gastric conduit. As in other gastrointestinal anastomosis, assessment of the anastomotic perfusion with fluorescence angiography could decrease this complication. We present a case in which Indocyanine Green (ICG) dye fluorescence was used to assess vascular perfusion for colonic interposition after graft necrosis in a patient with previous esophagectomy.
Abstract Every field of surgery has seen an explosion of new technologies aimed at improving surgical technique and reducing complications. The use of near-infrared (NIR) fluorescence to assess perfusion has been described in several surgical disciplines. NIR provides the surgeon with real-time perfusion assessment of a target organ or anastomosis and can be invaluable in aiding decision-making during the index operation. In the following article we discuss the use of fluorescence-guided perfusion assessment during colonic interposition for esophageal replacement. To our knowledge this is the first description of the use of fluorescence-guided perfusion assessment during colonic interposition. Keywords: ICG; colonic interposition; esophagus; fluorescence-guided surgery; near infrared.
Authors: Shiksha JoshiEmanuele Lo MenzoFernando DipSamuel SzomsteinRaul J. Rosenthal
Authors: M. Barberio M. Al‐Taher A. Forgione A. Hoskere Ashoka E. Felli V. Agnus J. Marescaux A. Klymchenko M. Diana
Authors: A. Vilar Tabanera M. Bajawi P. Abadía A. Puerta Vicente A. Ballestero D. Ramos I. Moreno J.D. Pina J. Die
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.