Κατεύθυνση Χειρουργική ΟγκολογίαLibrary of the School of Health Sciences
Πολυμενέας Γεώργιος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ, Επιβλέπων
Φραγκουλίδης Γεώργιος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Θεοδοσόπουλος Θεοδόσιος, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Η χρήση τεχνικών φθορισμού με το πράσινο της ινδοκυανίνης (ICG) στην λαπαροσκοπική χειρουργική ενδοπεριτοναϊκών και οπισθοπεριτοναϊκών όγκων
The clinical use of indocyanine green as fluorescent contrast agent for image guided laparoscopic surgery of intra and extraperitoneal malignancies
Background: Advances in laparoscopic imaging the past decade has brought to light new achievements as major contributions to intraoperative decision during laparoscopic procedures. Among these are the use of high definition and 3D imaging systems, and more recently indocyanine green (ICG) near infrared (NIR) fluorescence guided laparoscopy. The aim of this study was to present our experience with different laparoscopic procedures using ICG fluorescence imaging
Patients and methods: 69 ICG guided laparoscopic procedures were performed: 50 cholecystectomies (47 ellective and 3 urgent) 3 adrenalectomies, 3 segmental hepatectomies , 8 colectomies, 3 spleenctomies, 1 lymph node biopsy, 1 ligation of LMA after EVAR and 1 accesory spleen laparoscopic rescection mimicking pancreatic tail cancer. Visualization of structures was provided by a high resolution camera and a light source emitting both visible and near infra-red (NIR) light.
Results: After injection of ICG, vessels,organs and biliary structures were clearly identified. No injection-related adverse effects were reported. ICG-fluorescent imaging identified both of the microscopically confirmed HCC and CRC metastases
in surgical specimens. Also provide valuable information to conduct a safe laparoscopic cholecystectomy spleenectomy, adrenalectomy and ensure adequate vascular supply for colectomy, or find lymph nodes. There were no bile duct injuries or anastomotic leaks.
Conclusions: The use of (ICG), a non-radioactive, inexpensive fluorescent dye, in laparoscopic operations permits visualizing anatomic structures, perfusion and perfusion defects as well as the biliary and lymphatic system. In liver surgery, the system is used to visualize liver metastases or primary tumors of the liver. Due to its versatile cross-discipline applications, in our opinion we consider this fluorescence technology as a future standard imaging technique that will be found in every OR.
Main subject category:
Indocyanine green, ICG, Laparoscopy, Fluorescence, Surgical
Η ΧΡΗΣΗ ΤΕΧΝΙΚΩΝ ΦΘΟΡΙΣΜΟΥ ΜΕ ΤΟ ΠΡΑΣΙΝΟ ΤΗΣ ΙΝΔΟΚΥΑΝΙΝΗΣ (ICG) ΣΤΗΝ ΛΑΠΑΡΟΣΚΟΠΙΚΗ ΧΕΙΡΟΥΡΓΙΚΗ ΕΝΔΟΠΕΡΙΤΟΝΑΪΚΩΝ ΚΑΙ ΟΠΙΣΘΟΠΕΡΙΤΟΝΑΪΚΩΝ ΟΓΚΩΝ.pdf
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