Fernando Dip1,2, Luis Sarotto2, Mayank Roy1, Aaron Lee1, Emanuelle LoMenzo1, Matthew Walsh3, Thomas Carus4, Sylke Schneider5, Luigi Boni6, Takeaki Ishizawa7, Nohiro Kokudo7, Kevin White8, Raul J Rosenthal9. 1. Department of General Surgery, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL, 33331, USA. 2. Department of Surgery, Hospital de Clinicas José de San Martin, Buenos Aires, Argentina. 3. Department of General Surgery, Cleveland Clinic Cleveland, Cleveland, OH, USA. 4. Askelopios Westklinikum, Hamburg, Germany. 5. Klinikum Südstadt Rostock, Rostock, Germany. 6. University of Milan, Milan, Italy. 7. University of Tokyo, Tokyo, Japan. 8. ScienceRight Consulting, London, ON, Canada. 9. Department of General Surgery, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL, 33331, USA. rosentr@ccf.org.
Abstract
BACKGROUND: Incisionless fluorescent cholangiography (IFC) has recently been proven feasible, safe, and efficacious as an intraoperative procedure to help identify extrahepatic bile ducts during laparoscopic cholecystectomies (LC). We conducted a pilot survey of 51 surgeons attending an international conference who perform endoscopic cholecystectomies to identify their typical LC practices, and perceptions of IFC. METHODS: An international panel of ten IFC experts, all with > 500 prior IFC procedures and related research publications, convened during the 4th International Congress of Fluorescence-Guided Surgery in Boca Raton, Florida in February 2017. The panel was charged with developing questions about LC practices and experience with IFC, and perceptions regarding its advantages, barriers to use, and indications. These questions then were asked to other congress attendees during one of the didactic sessions using an online polling application. Attendees, who ranged from zero to considerable experience performing IFC, accessed the survey via their portable devices. RESULTS: Of the 51 survey participants, 51% were from North America; 77% identified themselves as general/minimally invasive surgeons, and roughly 60% performed under 50 cholecystectomies/year. Only 12% performed routine intraoperative cholangiography (IOC), while 72.3% routinely performed critical safety reviews. Thirty-five percent estimated that their institution's laparoscopic-to-open surgery conversion rate was > 1% during LC. Roughly 95% of respondents felt that surgeons should have access to a noninvasive method for evaluating extrahepatic biliary structures; 84% felt that the most advantageous characteristic of IFC is the lack of any biliary-tree incision; and 93.3% felt that IFC would have considerable educational value in surgical training programs; and 78% felt that any surgeon who performs LC could benefit. CONCLUSIONS: Surgeons who participated in our survey overwhelmingly recommended the routine use of IFC during laparoscopic cholecystectomy as a complimentary imaging technique. Prospective randomized clinical trials remain necessary to determine whether IFC reduces the incidence of bile duct injuries and other LC complications.
BACKGROUND: Incisionless fluorescent cholangiography (IFC) has recently been proven feasible, safe, and efficacious as an intraoperative procedure to help identify extrahepatic bile ducts during laparoscopic cholecystectomies (LC). We conducted a pilot survey of 51 surgeons attending an international conference who perform endoscopic cholecystectomies to identify their typical LC practices, and perceptions of IFC. METHODS: An international panel of ten IFC experts, all with > 500 prior IFC procedures and related research publications, convened during the 4th International Congress of Fluorescence-Guided Surgery in Boca Raton, Florida in February 2017. The panel was charged with developing questions about LC practices and experience with IFC, and perceptions regarding its advantages, barriers to use, and indications. These questions then were asked to other congress attendees during one of the didactic sessions using an online polling application. Attendees, who ranged from zero to considerable experience performing IFC, accessed the survey via their portable devices. RESULTS: Of the 51 survey participants, 51% were from North America; 77% identified themselves as general/minimally invasive surgeons, and roughly 60% performed under 50 cholecystectomies/year. Only 12% performed routine intraoperative cholangiography (IOC), while 72.3% routinely performed critical safety reviews. Thirty-five percent estimated that their institution's laparoscopic-to-open surgery conversion rate was > 1% during LC. Roughly 95% of respondents felt that surgeons should have access to a noninvasive method for evaluating extrahepatic biliary structures; 84% felt that the most advantageous characteristic of IFC is the lack of any biliary-tree incision; and 93.3% felt that IFC would have considerable educational value in surgical training programs; and 78% felt that any surgeon who performs LC could benefit. CONCLUSIONS: Surgeons who participated in our survey overwhelmingly recommended the routine use of IFC during laparoscopic cholecystectomy as a complimentary imaging technique. Prospective randomized clinical trials remain necessary to determine whether IFC reduces the incidence of bile duct injuries and other LC complications.
Authors: F Piacentini; S Perri; F Pietrangeli; M Nardi; A Dalla Torre; A Nicita; R Lotti; P Castaldo; F Gabbrielli; D Castiglia; G Citone Journal: G Chir Date: 2003-04
Authors: George Berci; John Hunter; Leon Morgenstern; Maurice Arregui; Michael Brunt; Brandon Carroll; Michael Edye; David Fermelia; George Ferzli; Frederick Greene; Joseph Petelin; Edward Phillips; Jeffrey Ponsky; Harry Sax; Steven Schwaitzberg; Nathaniel Soper; Lee Swanstrom; William Traverso Journal: Surg Endosc Date: 2013-01-26 Impact factor: 4.584
Authors: Fernando Dip; Emanuelle LoMenzo; Luis Sarotto; Edward Phillips; Hernan Todeschini; Mario Nahmod; Lisandro Alle; Sylke Schneider; Ludwig Kaja; Luigi Boni; Pedro Ferraina; Thomas Carus; Norihiro Kokudo; Takeaki Ishizawa; Mathew Walsh; Conrad Simpfendorfer; Roy Mayank; Kevin White; Raul J Rosenthal Journal: Ann Surg Date: 2019-12 Impact factor: 12.969
Authors: Mihai-Calin Pavel; Mar Achalandabaso Boira; Yasir Bashir; Robert Memba; Erik Llácer; Laia Estalella; Elisabeth Julià; Kevin C Conlon; Rosa Jorba Journal: Syst Rev Date: 2022-03-03
Authors: Fernando Dip; Luigi Boni; Michael Bouvet; Thomas Carus; Michele Diana; Jorge Falco; Geoffrey C Gurtner; Takeaki Ishizawa; Norihiro Kokudo; Emanuele Lo Menzo; Philip S Low; Jaume Masia; Derek Muehrcke; Francis A Papay; Carlo Pulitano; Sylke Schneider-Koraith; Danny Sherwinter; Giuseppe Spinoglio; Laurents Stassen; Yasuteru Urano; Alexander Vahrmeijer; Eric Vibert; Jason Warram; Steven D Wexner; Kevin White; Raul J Rosenthal Journal: Ann Surg Date: 2022-04-01 Impact factor: 13.787