Accurate localization of rectal cancer using near infrared ray-guided surgery with intra-operative colonoscopy and da Vinci Firefly technology

Abstract BACKGROUND Fluorescence-guided surgery (FGS) is under investigation as a means to improve the extent of resection for primary central nervous system (CNS) tumors. Tozuleristide, known also as “Tumor Paint,” is an investigational tumor-targeting agent covalently conjugated to a derivative of the fluorescent dye indocyanine green. OBJECTIVE To report the finding of avid intraoperative fluorescence of tozuleristide on cerebral vascular malformations. METHODS Our institution is participating in a phase 2/3 study of intraoperative near-infrared fluorescence detection of pediatric primary CNS tumors in patients receiving intravenous tozuleristide and imaged with the Canvas system. Our site enrolled 2 patients with intracranial lesions, suspected preoperatively of possibly being gliomas that proved to be cavernous vascular malformations after resection. RESULTS Each lesion had a dark blue mulberry appearance and each fluoresced avidly with tozuleristide. Each was completely resected, and the patients recovered without deficit. Pathological assessment showed cavernous angioma for both cases. Tozuleristide fluorescence is postulated to result from binding to matrix metalloproteinase-2 and annexin A2, and literature review demonstrates expression of both these ligands on multiple cerebrovascular lesions, including cavernous malformations. CONCLUSION This finding deserves further investigation to determine if tozuleristide “Tumor Paint” may have a wider role in the identification of non-neoplastic intracranial pathologies.

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SGM-101: An innovative near-infrared dye-antibody conjugate that targets CEA for fluorescence-guided surgery

Surgical Oncology ◽

10.1016/j.suronc.2017.03.002 ◽

2017 ◽

Vol 26 (2) ◽

pp. 153-162 ◽

Cited By ~ 25

Author(s):

Marian Gutowski ◽

Bérénice Framery ◽

Martin C. Boonstra ◽

Véronique Garambois ◽

François Quenet ◽

...

Keyword(s):

Near Infrared ◽

Guided Surgery ◽

Fluorescence Guided Surgery ◽

Antibody Conjugate ◽

Near Infrared Dye

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Accuracy of Near Infrared-Guided Surgery in Morbidly Obese Subjects Undergoing Laparoscopic Cholecystectomy

Obesity Surgery ◽

10.1007/s11695-015-1781-9 ◽

2015 ◽

Vol 26 (3) ◽

pp. 525-530 ◽

Cited By ~ 19

Author(s):

Fernando Dip ◽

David Nguyen ◽

Lisandro Montorfano ◽

María Eugenia Szretter Noste ◽

Emanuele Lo Menzo ◽

...

Keyword(s):

Laparoscopic Cholecystectomy ◽

Near Infrared ◽

Morbidly Obese ◽

Guided Surgery ◽

Obese Subjects

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Colorectal Cancer Surgery Using the Da Vinci Xi and Si Systems: Comparison of Perioperative Outcomes

Surgical Innovation ◽

10.1177/1553350618816788 ◽

2018 ◽

Vol 26 (2) ◽

pp. 192-200 ◽

Cited By ~ 4

Author(s):

Yu-Min Huang ◽

Yan Jiun Huang ◽

Po-Li Wei

Keyword(s):

Colorectal Cancer ◽

Rectal Cancer ◽

Da Vinci ◽

Operation Time ◽

Robotic System ◽

Cancer Surgery ◽

Perioperative Outcomes ◽

Da Vinci Xi ◽

Colorectal Cancer Surgery ◽

Estimated Blood Loss

Purpose. Robotic surgery for colorectal cancer is an emerging technique. Potential benefits as compared with the conventional laparoscopic surgery have been demonstrated. However, experience with the previous da Vinci Si robotic system revealed several unsolved problems. The novel features of the new da Vinci Xi increase operational flexibility and maneuverability and are expected to facilitate the performance of multiquadrant surgery. Methods. Between December 2011 and May 2015, 120 patients with colon or rectal cancer were operated on using the Si robotic system (the Si group). Between May 2015 and October 2017, 60 more patients with colon or rectal cancer were operated on using the Xi robotic system (the Xi group). The clinicopathological characteristics and perioperative outcomes of these 2 groups of patients were compared. Results. The 2 groups of patients were comparable with regard to baseline clinical characteristics, types of resection performed, and the proportion of patients undergoing neoadjuvant chemoradiation therapy. The statuses of resection margin, the numbers of lymph nodes harvested, and the rates of postoperative complications were also similar between the 2 groups. Nevertheless, a lower rate of diverting ileostomy, a shorter operation time, less estimated blood loss, and a faster postoperative recovery was observed in the Xi group. Conclusions. Colorectal cancer surgery using the Xi robotic system was associated with improved perioperative outcomes. These benefits may be attributed to its improved, more user-friendly design.

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The Fluostick, a real hand-held system for near-infrared fluorescence image-guided surgery

10.1117/12.2037577 ◽

2014 ◽

Cited By ~ 2

Author(s):

Paul Dorval ◽

Norman Mangeret ◽

Stephanie Guillermet ◽

Christian Adrien Righini ◽

Gabriele Barabino ◽

...

Keyword(s):

Near Infrared ◽

Image Guided Surgery ◽

Fluorescence Image ◽

Near Infrared Fluorescence ◽

Guided Surgery ◽

Image Guided ◽

Real Hand

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Application of indocyanine green-enhanced near-infrared fluorescence-guided imaging in laparoscopic lateral pelvic lymph node dissection for middle-low rectal cancer

World Journal of Gastroenterology ◽

10.3748/wjg.v25.i31.4502 ◽

2019 ◽

Vol 25 (31) ◽

pp. 4502-4511 ◽

Cited By ~ 6

Author(s):

Si-Cheng Zhou ◽

Yan-Tao Tian ◽

Xue-Wei Wang ◽

Chuan-Duo Zhao ◽

Shuai Ma ◽

...

Keyword(s):

Rectal Cancer ◽

Lymph Node ◽

Indocyanine Green ◽

Lymph Node Dissection ◽

Near Infrared ◽

Pelvic Lymph Node Dissection ◽

Low Rectal Cancer ◽

Node Dissection ◽

Lateral Pelvic Lymph Node ◽

Near Infrared Fluorescence

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Comparison of Clinical Efficacy and Safety Between da Vinci Robotic and Laparoscopic Intersphincteric Resection for Low Rectal Cancer: A Meta-Analysis

Frontiers in Surgery ◽

10.3389/fsurg.2021.752009 ◽

2021 ◽

Vol 8 ◽

Author(s):

Jie Zhang ◽

Xingshun Qi ◽

Fangfang Yi ◽

Rongrong Cao ◽

Guangrong Gao ◽

...

Keyword(s):

Rectal Cancer ◽

Clinical Efficacy ◽

Da Vinci ◽

Meta Analysis ◽

Outcome Data ◽

Intersphincteric Resection ◽

Low Rectal Cancer ◽

Cochrane Library ◽

Alternative Choice ◽

Laparoscopic Intersphincteric Resection

Background and Aims: The intersphincteric resection (ISR) is beneficial for saving patients' anus to a large extent and restoring original bowel continuity. Laparoscopic ISR (L-ISR) has its drawbacks, such as two-dimensional images, low motion flexibility, and unstable lens. Recently, da Vinci robotic ISR (R-ISR) is increasingly used worldwide. The purpose of this article is to compare the feasibility, safety, oncological outcomes, and clinical efficacy of R-ISR vs. L-ISR for low rectal cancer.Methods: PubMed, EMBASE, Cochrane Library, and Web of Science were searched to identify comparative studies of R-ISR vs. L-ISR. Demographic, clinical, and outcome data were extracted. Mean difference (MD) and risk ratio (RR) with their corresponding confidence intervals (CIs) were calculated.Results: Five studies were included. In total, 510 patients were included, of whom 273 underwent R-ISR and 237 L-ISR. Compared with L-ISR, R-ISR has significantly lower estimated intraoperative blood loss (MD = −23.31, 95% CI [−41.98, −4.64], P = 0.01), longer operative time (MD = 51.77, 95% CI [25.68, 77.86], P = 0.0001), hospitalization days (MD = −1.52, 95% CI [−2.10, 0.94], P < 0.00001), and postoperative urinary complications (RR = 0.36, 95% CI [0.16, 0.82], P = 0.02).Conclusions: The potential benefits of R-ISR are considered as a safe and feasible alternative choice for the treatment of low rectal tumors.

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