Thoracic Duct Lymphography by Near-Infrared Indocyanine Green Fluorescence imaging in Thoracic Surgery. A Review

Abstract Background: The pelvic autonomic nerves control and regulate anorectal and urogenital function. The dysfunction of pelvic autonomic nerves lead to disorders of anorectum, bladder and male sex organs. Thus the intraoperative identification of pelvic autonomic nerves could be crucial in complications prevention and diseases treatment. Our clinical trial aims at estimating the effectiveness and validity of intraoperative indocyanine green fluorescence imaging in pelvic autonomic nerves identification.Methods: Intraoperative fluorescence imaging using indocyanine green was performed in 10 patients and the feasibility was determined. From February 2019 to June 2019, the 10 patients undergoing laparoscopic colorectectomy was administrated 4.5 mg/Kg indocyanine green 24 hours before surgery. The near-infrared fluorescence imaging was conducted during surgery. A novel white light and near-infrared dual-channel laparoscopic equipment was applied. For each patient, signal background ratio values for pelvic autonomic nerves were recorded and analyzed.Results: We confirmed the best dose and timing of indocyanine green administration was 4.5 mg/Kg and 24 hours before surgery. Using the dual laparoscopic equipment, we could observe the splanchnic plexus, inferior mesenteric artery plexus, and sacral plexus successfully with a high signal background ratio value of 3.18 (standard deviation: 0.48). Conclusion: Pelvic autonomic nerves could be observed using indocyanine green fluorescence imaging during surgery. The novel method may replace the current visual identification method and become the standard clinical practice.

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Assessment of intraoperative use of indocyanine green fluorescence imaging on the number of lymph node dissection during minimally invasive gastrectomy: a systematic review and meta-analysis

10.37766/inplasy2021.11.0062 ◽

2021 ◽

Author(s):

Chun Deng ◽

◽

Zhenyu Zhang ◽

Zhi Guo ◽

Hengduo Qi ◽

...

Keyword(s):

Gastric Cancer ◽

Lymph Node ◽

Indocyanine Green ◽

Fluorescence Imaging ◽

Near Infrared ◽

Fluorescent Imaging ◽

Radical Gastrectomy ◽

Green Fluorescence ◽

Indocyanine Green Fluorescence ◽

Indocyanine Green Fluorescence Imaging

Review question / Objective: Whether is indocyanine green fluorescence imaging-guided lymphadenectomy feasible to improve the number of lymph node dissections during radical gastrectomy in patients with gastric cancer undergoing curative resection? Condition being studied: Gastric cancer was the sixth most common malignant tumor and the fourth leading cause of cancer-related death in the world. Radical lymphadenectomy was a standard procedure in radical gastrectomy for gastric cancer. The retrieval of more lymph nodes was beneficial for improving the accuracy of tumor staging and the long-term survival of patients with gastric cancer. Indocyanine green(ICG) near-infrared fluorescent imaging has been found to provide surgeons with effective visualization of the lymphatic anatomy. As a new surgical navigation technique, ICG near-infrared fluorescent imaging was a hot spot and had already demonstrated promising results in the localization of lymph nodes during surgery in patients with breast cancer, non–small cell lung cancer, and gastric cancer. In addition, ICG had increasingly been reported in the localization of tumor, lymph node dissection, and the evaluation of anastomotic blood supply during radical gastrectomy for gastric cancer. However, it remained unclear whether ICG fluorescence imaging would assist surgeons in performing safe and sufficient lymphadenectomy.

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Near-infrared Intraoperative Imaging of Pelvic Autonomic Nerves: Clinical Trial

10.21203/rs.3.rs-117769/v1 ◽

2020 ◽

Author(s):

Hao Jin ◽

Ligong Lu ◽

Min Cui

Keyword(s):

Clinical Trial ◽

Indocyanine Green ◽

Fluorescence Imaging ◽

Near Infrared ◽

Autonomic Nerves ◽

Green Fluorescence ◽

Indocyanine Green Fluorescence ◽

Laparoscopic Equipment ◽

Indocyanine Green Fluorescence Imaging ◽

Pelvic Autonomic Nerves

Abstract Background: The pelvic autonomic nerves control and regulate anorectal and urogenital function. The dysfunction of pelvic autonomic nerves lead to disorders of anorectum, bladder and male sex organs. Thus the intraoperative identification of pelvic autonomic nerves could be crucial in complications prevention and diseases treatment. Our clinical trial aims at estimating the effectiveness and validity of intraoperative indocyanine green fluorescence imaging in pelvic autonomic nerves identification.Methods: Intraoperative fluorescence imaging using indocyanine green was performed in 10 patients and the feasibility was determined. From February 2019 to June 2019, the 10 patients undergoing laparoscopic colorectectomy was administrated 4.5 mg/Kg indocyanine green 24 hours before surgery. The near-infrared fluorescence imaging was conducted during surgery. A novel white light and near-infrared dual-channel laparoscopic equipment was applied. For each patient, signal background ratio values for pelvic autonomic nerves were recorded and analyzed.Results: We confirmed the best dose and timing of indocyanine green administration was 4.5 mg/Kg and 24 hours before surgery. Using the dual laparoscopic equipment, we could observe the splanchnic plexus, inferior mesenteric artery plexus, and sacral plexus successfully with a high signal background ratio value of 3.18 (standard deviation: 0.48). Conclusion: Pelvic autonomic nerves could be observed using indocyanine green fluorescence imaging during surgery. The novel method may replace the current visual identification method and become the standard clinical practice.

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