The utility of indocyanine green fluorescence imaging during robotic adrenalectomy

Background and Objectives Indocyanine green (ICG) has been used for medical imaging since 1950s, but has more recently become available for use in minimally invasive surgery owing to improvements in technology. This study investigates the use of ICG florescence to guide an accurate dissection by del...

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Bibliographic Details
Published in:Journal of surgical oncology 2016-08, Vol.114 (2), p.153-156
Main Authors: Colvin, Jennifer, Zaidi, Nisar, Berber, Eren
Format: Article
Language:English
Subjects:
Adrenal Gland Neoplasms - diagnosis
Adrenal Gland Neoplasms - surgery
Adrenalectomy - methods
endocrine surgery
Female
fluorescence-guided
Humans
Indocyanine Green
Male
Middle Aged
minimally invasive
near-infrared imaging
Optical Imaging - methods
Prospective Studies
robotic adrenalectomy
Robotic Surgical Procedures - methods
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Summary:Background and Objectives Indocyanine green (ICG) has been used for medical imaging since 1950s, but has more recently become available for use in minimally invasive surgery owing to improvements in technology. This study investigates the use of ICG florescence to guide an accurate dissection by delineating the borders of adrenal tumors during robotic adrenalectomy (RA). Methods This prospective study compared conventional robotic view with ICG fluorescence imaging in 40 consecutive patients undergoing RA. Independent, non‐blinded observers assessed how accurately ICG fluorescence delineated the borders of adrenal tumors compared to conventional robotic view. Results A total of 40 patients underwent 43 adrenalectomies. ICG imaging was superior, equivalent, or inferior to conventional robotic view in 46.5% (n = 20), 25.6% (n = 11), and 27.9% (n = 12) of the procedures. On univariate analysis, the only parameter that predicted the superiority of ICG imaging over conventional robotic view was the tumor type, with adrenocortical tumors being delineated more accurately on ICG imaging compared to conventional robotic view. Conclusions This study demonstrates the utility of ICG to guide the dissection and removal of adrenal tumors during RA. A simple reproducible method is reported, with a detailed description of the utility based on tumor type, approach and side. J. Surg. Oncol. 2016;114:153–156. © 2016 Wiley Periodicals, Inc.
ISSN:0022-4790
1096-9098
DOI:10.1002/jso.24296