476 ICG FLUORESCENCE IN IDENTIFICATION OF THORACIC DUCT

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.

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

Diseases of the Esophagus ◽

10.1093/dote/doaa087.119 ◽

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.

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Intraoperative fluorescence-based enhanced reality laparoscopic real-time imaging to assess bowel perfusion at the anastomotic site in an experimental model

British Journal of Surgery ◽

10.1002/bjs.9725 ◽

2015 ◽

Vol 102 (2) ◽

pp. e169-e176 ◽

Cited By ~ 61

Author(s):

M. Diana ◽

V. Agnus ◽

P. Halvax ◽

Y.-Y. Liu ◽

B. Dallemagne ◽

...

Keyword(s):

Real Time ◽

Experimental Model ◽

Anastomotic Site ◽

Real Time Imaging ◽

Bowel Perfusion ◽

Enhanced Reality ◽

Intraoperative Fluorescence

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New generation of magnetic and luminescent nanoparticles for in vivo real-time imaging

Interface Focus ◽

10.1098/rsfs.2012.0103 ◽

2013 ◽

Vol 3 (3) ◽

pp. 20120103 ◽

Cited By ~ 19

Author(s):

Lise-Marie Lacroix ◽

Fabien Delpech ◽

Céline Nayral ◽

Sébastien Lachaize ◽

Bruno Chaudret

Keyword(s):

Contrast Agents ◽

Real Time ◽

Metallic Nanoparticles ◽

Surface Engineering ◽

Semiconductor Nanocrystals ◽

Fluorescent Imaging ◽

Real Time Imaging ◽

Specific Targeting ◽

New Generation

A new generation of optimized contrast agents is emerging, based on metallic nanoparticles (NPs) and semiconductor nanocrystals for, respectively, magnetic resonance imaging (MRI) and near-infrared (NIR) fluorescent imaging techniques. Compared with established contrast agents, such as iron oxide NPs or organic dyes, these NPs benefit from several advantages: their magnetic and optical properties can be tuned through size, shape and composition engineering, their efficiency can exceed by several orders of magnitude that of contrast agents clinically used, their surface can be modified to incorporate specific targeting agents and antifolding polymers to increase blood circulation time and tumour recognition, and they can possibly be integrated in complex architecture to yield multi-modal imaging agents. In this review, we will report the materials of choice based on the understanding of the basic physics of NIR and MRI techniques and their corresponding syntheses as NPs. Surface engineering, water transfer and specific targeting will be highlighted prior to their first use for in vivo real-time imaging. Highly efficient NPs that are safer and target specific are likely to enter clinical application in a near future.

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