Antonio S Soares1, Laurence B Lovat2, Manish Chand3. 1. Wellcome EPSRC Centre for Interventional and Surgical Sciences (WEISS), UK; Division of Surgery and Interventional Sciences, University College London, UK. 2. Wellcome EPSRC Centre for Interventional and Surgical Sciences (WEISS), UK. 3. Wellcome EPSRC Centre for Interventional and Surgical Sciences (WEISS), UK; Division of Surgery and Interventional Sciences, University College London, UK. Electronic address: m.chand@ucl.ac.uk.
Abstract
INTRODUCTION: The best approach to lymphadenectomy in colon cancer is still unknown. The debate has centred around different options of standardised "one size fits all" lymph node harvest techniques. A different approach is tailoring lymph node harvest to the patient's lymphatic drainage pattern. METHODS: A technique for individualised lymph node mapping is proposed, which can guide the surgeon intraoperatively. It consists in the intracorporeal injection of 10 mg of indocyanine green at 4 points in the periphery of the colonic tumour. A near infrared camera is used to assess the fluorescence after specimen mobilisation but before extraction, allowing lymphadenectomy based on the patient's own lymphatic drainage. RESULTS: a video demonstration of the technique and preliminary results in 6 patients is presented in this short report. CONCLUSION: intracorporeal lymph node mapping is feasible and safe. Further studies are required to determine the place of this technique in modern oncologic colon surgery.
INTRODUCTION: The best approach to lymphadenectomy in colon cancer is still unknown. The debate has centred around different options of standardised "one size fits all" lymph node harvest techniques. A different approach is tailoring lymph node harvest to the patient's lymphatic drainage pattern. METHODS: A technique for individualised lymph node mapping is proposed, which can guide the surgeon intraoperatively. It consists in the intracorporeal injection of 10 mg of indocyanine green at 4 points in the periphery of the colonic tumour. A near infrared camera is used to assess the fluorescence after specimen mobilisation but before extraction, allowing lymphadenectomy based on the patient's own lymphatic drainage. RESULTS: a video demonstration of the technique and preliminary results in 6 patients is presented in this short report. CONCLUSION: intracorporeal lymph node mapping is feasible and safe. Further studies are required to determine the place of this technique in modern oncologic colon surgery.