BACKGROUND: Accurate identification of the location of colorectal lesions is crucial during laparoscopic surgery. Endoscopic marking has been used as an effective preoperative marker for tumor identification. OBJECTIVE: We investigated the feasibility and safety of an imaging method using near-infrared, light-emitting, diode-activated indocyanine green fluorescence in colorectal laparoscopic surgery. DESIGN: This was a single-institution, prospective study. SETTINGS: This study was conducted in a tertiary referral hospital. PATIENTS: We enrolled 24 patients who underwent laparoscopic surgery. MAIN OUTCOME MEASURES: Indocyanine green and India ink were injected into the same patients undergoing preoperative colonoscopy for colon cancer. During subsequent laparoscopic resection of colorectal tumors, the colon was first observed with white light. Then, indocyanine green was activated with a light-emitting diode at 760 nm as the light source. RESULTS: Near-infrared-induced fluorescence showed tumor location clearly and accurately in all 24 of the patients. All of the patients who underwent laparoscopic surgery after marking had positive indocyanine green staining at the time of surgery. Perioperative complications attributed to dye use were not observed. LIMITATIONS: This study is limited by the cost of indocyanine green detection, the timing of the colonoscopy and tattooing in relation to the operation and identification with indocyanine green, and the small size of the series. CONCLUSIONS: These data suggest that our novel method for colonic marking with fluorescence imaging of near-infrared, light-emitting, diode-activated indocyanine green is feasible and safe. This method is useful, has no adverse effects, and can be used for perioperative identification of tumor location. Near-infrared, light-emitting, diode-activated indocyanine green has potential use as a colonic marking agent.
BACKGROUND: Accurate identification of the location of colorectal lesions is crucial during laparoscopic surgery. Endoscopic marking has been used as an effective preoperative marker for tumor identification. OBJECTIVE: We investigated the feasibility and safety of an imaging method using near-infrared, light-emitting, diode-activated indocyanine green fluorescence in colorectal laparoscopic surgery. DESIGN: This was a single-institution, prospective study. SETTINGS: This study was conducted in a tertiary referral hospital. PATIENTS: We enrolled 24 patients who underwent laparoscopic surgery. MAIN OUTCOME MEASURES: Indocyanine green and India ink were injected into the same patients undergoing preoperative colonoscopy for colon cancer. During subsequent laparoscopic resection of colorectal tumors, the colon was first observed with white light. Then, indocyanine green was activated with a light-emitting diode at 760 nm as the light source. RESULTS: Near-infrared-induced fluorescence showed tumor location clearly and accurately in all 24 of the patients. All of the patients who underwent laparoscopic surgery after marking had positive indocyanine green staining at the time of surgery. Perioperative complications attributed to dye use were not observed. LIMITATIONS: This study is limited by the cost of indocyanine green detection, the timing of the colonoscopy and tattooing in relation to the operation and identification with indocyanine green, and the small size of the series. CONCLUSIONS: These data suggest that our novel method for colonic marking with fluorescence imaging of near-infrared, light-emitting, diode-activated indocyanine green is feasible and safe. This method is useful, has no adverse effects, and can be used for perioperative identification of tumor location. Near-infrared, light-emitting, diode-activated indocyanine green has potential use as a colonic marking agent.
Authors: Deborah S Keller; Richard Boulton; Manuel Rodriguez-Justo; Richard Cohen; Manish Chand Journal: J Fluoresc Date: 2018-04-26 Impact factor: 2.217
Authors: Adrian Garcia Badaracco; Erin Ward; Christopher Barback; Jian Yang; James Wang; Ching-Hsin Huang; Moon Kim; Qingxiao Wang; Seungjin Nam; Jonathan Delong; Sarah Blair; William C Trogler; Andrew Kummel Journal: Appl Surf Sci Date: 2019-09-05 Impact factor: 6.707