Near-infrared laparoscopy for real-time intra-operative arterial and lymphatic perfusion imaging

Multimodal laparoscopic imaging systems possessing the capability for extended spectrum irradiation and visualization within a unified camera system are now available to provide enhanced intracorporeal operative anatomic and dynamic perfusion assessment and potentially augmented patient outcome. Whi...

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Bibliographic Details
Published in:Colorectal disease 2011-11, Vol.13 (s7), p.12-17
Main Authors: Cahill, R. A., Ris, F., Mortensen, N. J.
Format: Article
Language:English
Subjects:
Anastomosis, Surgical
anastomotic complications
Angiography
Cholangiography
Colon - surgery
Colorectal Neoplasms - pathology
Colorectal Neoplasms - surgery
Esophagus - diagnostic imaging
Fluorescence
Fluorescent Dyes
Humans
Indocyanine Green
indocyanine green (ICG)
Laparoscopic colorectal surgery
Laparoscopy - instrumentation
lymphatic mapping
Lymphatic Metastasis
Lymphography
near-infrared laparoscopy
on table angiography
Rectum - surgery
Spectroscopy, Near-Infrared - instrumentation
Ureter - diagnostic imaging
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Summary:Multimodal laparoscopic imaging systems possessing the capability for extended spectrum irradiation and visualization within a unified camera system are now available to provide enhanced intracorporeal operative anatomic and dynamic perfusion assessment and potentially augmented patient outcome. While ultraviolet‐range energies have limited penetration and hence are probably more useful for endoscopic mucosal interrogation, the near‐infrared (NIR) spectrum is of greater potential utility for the purposes of examining inducible fluorescence in abdominopelvic tissue that can be achieved by administration of specific tracer agents, either directly into the circulation (e.g. for anastomotic perfusion assessment at the time of stapling) or into the lymphatic system (e.g. for lymph basin road‐mapping and/or focussed target nodal assessment). This technology is also capable of supplementing anatomic recognition of the biliary system while implantable fibres can also be inserted intraoperatively for the purpose of safeguarding vital structures such as the oesphagus and ureters especially in difficult reoperations. It is likely that this technological capability will find a clear and common indication in colorectal specialist and general surgical departments worldwide in the near future.
ISSN:1462-8910
1463-1318
DOI:10.1111/j.1463-1318.2011.02772.x