465 VISUALISATION OF THORACIC DUCT DURING ESOPHAGECTOMY BY REAL-TIME FLUORESCENT IMAGING—A TECHNIQUE IN EVOLUTION

2020 ◽  
Vol 33 (Supplement_1) ◽  
Author(s):  
S Thammineedi
Keyword(s):  
Indocyanine Green ◽  
Real Time ◽  
Thoracic Duct ◽  
Near Infrared ◽  
Thoracoscopic Surgery ◽  
Minimally Invasive Esophagectomy ◽  
Fluorescent Imaging ◽  
Bench Mark ◽  
Real Time Imaging ◽  
Invasive Esophagectomy

Abstract   Recognition and repair of thoracic duct and it’s injury make the management of chyle leak difficult. Traditional methods like lymphoscintigraphy, lymphangiography and preoperative oral cream ingestion to identify the thoracic duct find limited use in intraoperative identification with poor contrast and precision. Near-infrared (NIR) fluorescence by indocyanine green dye (ICG) provides a feasible, real-time imaging of thoracic ductal anatomy during thoracoscopic surgery, thereby potentially reducing injury of thoracic duct. Methods We describe successful identification of the thoracic duct in real-time during minimally invasive esophagectomy by Indocyanine green (ICG) lymphangiography in a series of 10 patients with carcinoma esophagus post chemoradiotherapy. Intraoperative fluorescence lymphangiography was performed by injecting 2.5 to 7.5 mg of ICG. into small bowel mesentery in 5, groin in 2 and both mesentery and groin in 3. Results Time required for appearance of ICG fluorescence in thoracic duct ranged from 60 to 120 min. Thoracic duct was successfully identified and delineated in 8 cases, and not detected in 2 cases. There were no chyle leaks in the postoperative period, and all the patients were discharged uneventfully. Conclusion ICG fluorescence lymphangiography provides a feasible, reliable, and real-time imaging of thoracic duct during esophagectomy, thereby potentially reducing the thoracic duct injuries. In this series the non detection of thoracic duct in cases and the appearance of fluorescence at varied interval of time might be due to erratic expression of ICG fluorescence owing to extensive fibrosis in thorax secondarily to chemoradiation. This study should serve as a bench mark for larger studies in future.

476 ICG FLUORESCENCE IN IDENTIFICATION OF THORACIC DUCT

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Subramanyeshwar Rao Thammineedi
Keyword(s):  
Small Bowel ◽  
Real Time ◽  
Thoracic Duct ◽  
Fluorescent Imaging ◽  
Small Bowel Mesentery ◽  
Video Presentation ◽  
Real Time Imaging ◽  
Intraoperative Fluorescence

Abstract   Not applicable because it is a Video presentation. Methods Not applicable because it is a Video presentation. Results Not applicable because it is a Video presentation. Conclusion Not applicable because it is a Video presentation. Video Video shows visualisation of thoracic duct during esophagectomy by real-time fluorescent imaging. Intraoperative fluorescence lymphangiography was performed by injecting 2.5 mg of ICG into small bowel mesentery at Laparoscopy.At Thoracoscopy, Thoracic duct was visualised after 65 minutes. ICG fluorescence lymphangiography provides a feasible, reliable and real-time imaging of thoracic duct during esophagectomy, thereby potentially reducing thoracic duct injuries. https://drive.google.com/open?id=1ROGQ1K-yWkO-B3oSk8dGbsRu4iCKGfJq.

scholarly journals Thoracic duct identification with indocyanine green fluorescence during minimally invasive esophagectomy with patient in prone position

2020 ◽  
Vol 33 (12) ◽  
Author(s):  
Massimo Vecchiato ◽  
Antonio Martino ◽  
Massimo Sponza ◽  
Alessandro Uzzau ◽  
Antonio Ziccarelli ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Indocyanine Green ◽  
Prone Position ◽  
Thoracic Duct ◽  
Minimally Invasive Esophagectomy ◽  
Standard Procedure ◽  
Transthoracic Esophagectomy ◽  
Green Fluorescence ◽  
Indocyanine Green Fluorescence ◽  
Invasive Esophagectomy

Abstract Chylothorax is a serious complication of transthoracic esophagectomy. Intraoperative thoracic duct (TD) identification represents a possible tool for preventing or repairing its lesions, and it is most of the time difficult, even during high-definition thoracoscopy. The aim of the study is to demonstrate the feasibility of using near-infrared fluorescence-guided thoracoscopy to identify TD anatomy and check its intraoperative lesions during minimally invasive esophagectomy. A 0.5 mg/kg solution of indocyanine green (ICG) was injected percutaneously in the inguinal nodes of 19 patients undergoing minimally invasive esophagectomy in a prone position, before thoracoscopy. TD anatomy and potential intraoperative lesions were checked with the KARL STORZ OPAL1® Technology. In all of the 19 patients where transthoracic esophagectomy was feasible, the TD was clearly identified after a mean of 52.7 minutes from injection time. The TD was cut for oncological radicality in two patients, and it was successfully ligated under the ICG guide. No postoperative chylothorax or adverse reactions from the ICG injection occurred. The TD identification with indocyanine green fluorescence during minimally invasive esophagectomy is a simple, effective, and non-time-demanding tool; it may become a standard procedure to prevent postoperative chylothorax.

scholarly journals Intraoperative Near-Infrared Fluorescence Imaging as an Adjunct to Robotic-Assisted Minimally Invasive Esophagectomy

2014 ◽  
Vol 9 (5) ◽  
pp. 391-393 ◽  
Author(s):  
Inderpal S. Sarkaria ◽  
Manjit S. Bains ◽  
David J. Finley ◽  
Prasad S. Adusumilli ◽  
James Huang ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Indocyanine Green ◽  
Fluorescence Imaging ◽  
Near Infrared ◽  
Minimally Invasive Esophagectomy ◽  
Near Infrared Fluorescence ◽  
Robotic Assisted ◽  
Invasive Esophagectomy ◽  
Vascular Arcade ◽  
Near Infrared Fluorescence Imaging

During esophagectomy, identification and preservation of the right gastroepiploic vascular arcade are critical and may be challenging with minimally invasive approaches. We assessed the use of near-infrared fluorescence imaging fluorescence angiography (NIFI-FA) during robotic-assisted minimally invasive esophagectomy (RAMIE) as an aid to visualize the gastric vasculature with mobilization. After intravenous administration of 10 mg of indocyanine green, a robotic platform with near-infrared optical fluorescence capability was used to examine the gastric vasculature in patients undergoing RAMIE. Thirty (71%) of 42 patients undergoing RAMIE were assessed using NIFI-FA during mobilization of the greater gastric curve and fundus; 11 were excluded because the system was not available, and 1 was excluded because of documented allergy to iodinated contrast. The median time from indocyanine green administration to detectable fluorescence was 37.5 seconds (range, 20–105 seconds). Near-infrared fluorescence imaging FA identified or confirmed termination of the vascular arcade in all 30 cases. Subjectively, NIFI-FA often identified otherwise unvisualized small transverse vessels between the termination of the vascular arcade and the first short gastric artery, as well as between the short gastric arteries. Identification and/or confirmation of the vascular arcade position during mobilization of the greater curve/omentum were also aided by NIFI-FA. Although there are limitations to the current technology, NIFI-FA may be a useful adjunct to confirm and identify the position of gastroepiploic vessels, allow for safer and more confident dissections during gastric mobilization, as well as potentially decrease serious intraoperative vascular misadventures.

Near-infrared fluorescence cholangiography with indocyanine green for biliary atresia. Real-time imaging during the Kasai procedure: a pilot study

2015 ◽  
Vol 31 (12) ◽  
pp. 1177-1182 ◽  
Author(s):  
Yutaka Hirayama ◽  
Yasushi Iinuma ◽  
Naoyuki Yokoyama ◽  
Tetsuya Otani ◽  
Daisuke Masui ◽  
...  
Keyword(s):  
Pilot Study ◽  
Indocyanine Green ◽  
Biliary Atresia ◽  
Real Time ◽  
Near Infrared ◽  
Near Infrared Fluorescence ◽  
Real Time Imaging ◽  
Kasai Procedure

scholarly journals Digital dynamic discrimination of primary colorectal cancer using systemic indocyanine green with near-infrared endoscopy

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jeffrey Dalli ◽  
Eamon Loughman ◽  
Niall Hardy ◽  
Anwesha Sarkar ◽  
Mohammad Faraz Khan ◽  
...  
Keyword(s):  
Indocyanine Green ◽  
Real Time ◽  
Normal Tissue ◽  
Near Infrared ◽  
Malignant Lesion ◽  
Fluorescence Analysis ◽  
Video Tracking ◽  
Continuous Stream ◽  
Rich Data

AbstractAs indocyanine green (ICG) with near-infrared (NIR) endoscopy enhances real-time intraoperative tissue microperfusion appreciation, it may also dynamically reveal neoplasia distinctively from normal tissue especially with video software fluorescence analysis. Colorectal tumours of patients were imaged mucosally following ICG administration (0.25 mg/kg i.v.) using an endo-laparoscopic NIR system (PINPOINT Endoscopic Fluorescence System, Stryker) including immediate, continuous in situ visualization of rectal lesions transanally for up to 20 min. Spot and dynamic temporal fluorescence intensities (FI) were quantified using ImageJ (including videos at one frame/second, fps) and by a bespoke MATLAB® application that provided digitalized video tracking and signal logging at 30fps (Fluorescence Tracker App downloadable via MATLAB® file exchange). Statistical analysis of FI-time plots compared tumours (benign and malignant) against control during FI curve rise, peak and decline from apex. Early kinetic FI signal measurement delineated discriminative temporal signatures from tumours (n = 20, 9 cancers) offering rich data for analysis versus delayed spot measurement (n = 10 cancers). Malignant lesion dynamic curves peaked significantly later with a shallower gradient than normal tissue while benign lesions showed significantly greater and faster intensity drop from apex versus cancer. Automated tracker quantification efficiently expanded manual results and provided algorithmic KNN clustering. Photobleaching appeared clinically irrelevant. Analysis of a continuous stream of intraoperatively acquired early ICG fluorescence data can act as an in situ tumour-identifier with greater detail than later snapshot observation alone. Software quantification of such kinetic signatures may distinguish invasive from non-invasive neoplasia with potential for real-time in silico diagnosis.

Design of a control system for a visible/near-infrared real-time imaging spectrometer

2021 ◽  
Vol 14 (0) ◽  
pp. 1-7
Author(s):  
WU Chang-kun ◽  
◽  
◽  
ZHANG Wei ◽  
HAO Ya-zhe
Keyword(s):  
Control System ◽  
Real Time ◽  
Near Infrared ◽  
Imaging Spectrometer ◽  
Real Time Imaging

Detection of the Communication Site by Indocyanine Green Adsorbed to Human Serum Albumin Fluorescence During Surgery for a Pleuroperitoneal Communication

2021 ◽  
Author(s):  
Daisuke Kimura ◽  
Ikuo Fukuda ◽  
Takeshi Fujita ◽  
Reiichi Murakami ◽  
Norio Nakamura ◽  
...  
Keyword(s):  
Human Serum Albumin ◽  
Serum Albumin ◽  
Indocyanine Green ◽  
Human Serum ◽  
Near Infrared ◽  
Thoracoscopic Surgery ◽  
Good Method ◽  
Pleuroperitoneal Communication ◽  
Fluorescence Images ◽  
One Year

Abstract A pleuroperitoneal communication is a serious complication for patients undergoing continuous ambulatory peritoneal dialysis (CAPD). Video-assisted thoracoscopic surgery is performed using indocyanine green adsorbed to human serum albumin fluorescence to identify the communication because human serum albumin reinforces fluorescence images. A patient diagnosed with a pleuroperitoneal communication was referred to our department and underwent surgery. To detect the communication, a dialysate mixture that contained indocyanine green and human serum albumin was injected from the CAPD catheter. Real-time fluorescence images were able to clearly show a bleb-like lesion with a near-infrared spectroscopy camera, and the site was repaired. The patient had no recurrence at one-year follow-up. This method might be good method for pleuroperitoneal communication surgery.

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