OBJECTIVE: Laparoscopic adrenalectomy has become the standard of care for many adrenal tumors. However, the success of the operation hinges on identifying the adrenal vein and complete tumor resection. We demonstrate the use of a commercially available near infrared fluorescent imaging system to clearly delineate the vascular anatomy of adrenal neoplasms and enhance the border between tumor and normal tissue. We hypothesize that this will increase the safety of laparoscopic adrenalectomy. MATERIALS AND METHODS: We performed laparoscopic adrenalectomy utilizing indocyanine green (ICG) and a specialized laparoscopic fluorescence imaging system on four consecutive patients undergoing laparoscopic adrenalectomy over a 4-month period. RESULTS: The adrenal arteries and vein were vividly enhanced with ICG fluorescence guidance, and the border between tumor and adjacent tissue was clearly demarcated. The operations were performed safely with minimal blood loss and short operative times. There were no complications. CONCLUSIONS: Adrenal neoplasms can be resected laparoscopically under ICG fluorescence guidance and can be used to clearly identify vascular structures and enhance the borders of the tumor. This technique allows for clear identification of the adrenal vein and has the potential to improve the safety of laparoscopic adrenalectomy.
OBJECTIVE: Laparoscopic adrenalectomy has become the standard of care for many adrenal tumors. However, the success of the operation hinges on identifying the adrenal vein and complete tumor resection. We demonstrate the use of a commercially available near infrared fluorescent imaging system to clearly delineate the vascular anatomy of adrenal neoplasms and enhance the border between tumor and normal tissue. We hypothesize that this will increase the safety of laparoscopic adrenalectomy. MATERIALS AND METHODS: We performed laparoscopic adrenalectomy utilizing indocyanine green (ICG) and a specialized laparoscopic fluorescence imaging system on four consecutive patients undergoing laparoscopic adrenalectomy over a 4-month period. RESULTS: The adrenal arteries and vein were vividly enhanced with ICG fluorescence guidance, and the border between tumor and adjacent tissue was clearly demarcated. The operations were performed safely with minimal blood loss and short operative times. There were no complications. CONCLUSIONS:Adrenal neoplasms can be resected laparoscopically under ICG fluorescence guidance and can be used to clearly identify vascular structures and enhance the borders of the tumor. This technique allows for clear identification of the adrenal vein and has the potential to improve the safety of laparoscopic adrenalectomy.
Authors: Kiranya E Tipirneni; Jason M Warram; Lindsay S Moore; Andrew C Prince; Esther de Boer; Aditi H Jani; Irene L Wapnir; Joseph C Liao; Michael Bouvet; Nicole K Behnke; Mary T Hawn; George A Poultsides; Alexander L Vahrmeijer; William R Carroll; Kurt R Zinn; Eben Rosenthal Journal: Ann Surg Date: 2017-07 Impact factor: 12.969
Authors: Maximilian Lerchenberger; Ufuk Gündogar; Norah Al Arabi; Julia K S Gallwas; Herbert Stepp; Klaus K J Hallfeldt; Roland Ladurner Journal: Surg Endosc Date: 2019-07-24 Impact factor: 4.584
Authors: Barbara Seeliger; Martin K Walz; Pier F Alesina; Vincent Agnus; Raoul Pop; Manuel Barberio; Alend Saadi; Marc Worreth; Jacques Marescaux; Michele Diana Journal: Surg Endosc Date: 2019-07-23 Impact factor: 4.584
Authors: Neel Rajan; Steven D Scoville; Tong Zhang; Priya H Dedhia; Barbra S Miller; Matthew D Ringel; Abberly Lott Limbach; John E Phay Journal: J Endocr Soc Date: 2022-08-15
Authors: Labrinus van Manen; Henricus J M Handgraaf; Michele Diana; Jouke Dijkstra; Takeaki Ishizawa; Alexander L Vahrmeijer; Jan Sven David Mieog Journal: J Surg Oncol Date: 2018-06-24 Impact factor: 3.454