講演情報
[E2-3]ICG Fluorescence Imaging allows Navigation of Critical Vessels during Laparoscopic and Robotic Colorectal Surgery
Trevor M Yeung, Wing Wa Leung, Prudence Tam, Ruby Lau, Julie Ng, Nicole Cheng, Vienna Ng, Cherry Wong, Simon Chu, Sophie S Hon, Kaori Futaba, Simon S Ng (The Chinese University of Hong Kong)
Introduction
This study assesses the role of Indocyanine Green (ICG) in identifying critical vessels in both laparoscopic and robotic colorectal surgery and surgeon satisfaction in the use of this technology.
Methods
This was a prospective single-center study that included patients undergoing laparoscopic and robotic surgery for colorectal cancer. A low dose of ICG was injected intravenously intraoperatively to visualize critical vascular structures, using the Visera Elite III laparoscopic system and Da Vinci Xi Firefly robotic system. Primary outcome was the identification of critical vascular structures under fluorescence imaging. Secondary outcomes included time to visualise vessels under fluorescence, any change in surgical plan, and surgeon ratings on strength of signal, ease of use, helpfulness and overall satisfaction assessed using a Likert scale.
Results
Eight patients (four right sided resections, four left sided resections) were included. ICG successfully identified critical vascular structures in all cases, with visualization occurring 22-35 seconds after injection. The optimal dose was 2.5mg. In four patients, ICG identified critical vessels which altered surgical plan, including an aberrant ascending branch of the left colic artery, an accessory vessel in close proximity to the IMV and, in two cases, the marginal artery in the mesocolon of the colonic conduit. Surgeons reported high satisfaction with the use of ICG in vessel navigation.
Conclusion
ICG fluorescence imaging is a valuable tool for identifying critical vascular structures during minimally invasive colorectal surgery, improving surgical precision and decision-making, with high surgeon satisfaction. Further studies are needed to assess its impact on patient outcomes.
This study assesses the role of Indocyanine Green (ICG) in identifying critical vessels in both laparoscopic and robotic colorectal surgery and surgeon satisfaction in the use of this technology.
Methods
This was a prospective single-center study that included patients undergoing laparoscopic and robotic surgery for colorectal cancer. A low dose of ICG was injected intravenously intraoperatively to visualize critical vascular structures, using the Visera Elite III laparoscopic system and Da Vinci Xi Firefly robotic system. Primary outcome was the identification of critical vascular structures under fluorescence imaging. Secondary outcomes included time to visualise vessels under fluorescence, any change in surgical plan, and surgeon ratings on strength of signal, ease of use, helpfulness and overall satisfaction assessed using a Likert scale.
Results
Eight patients (four right sided resections, four left sided resections) were included. ICG successfully identified critical vascular structures in all cases, with visualization occurring 22-35 seconds after injection. The optimal dose was 2.5mg. In four patients, ICG identified critical vessels which altered surgical plan, including an aberrant ascending branch of the left colic artery, an accessory vessel in close proximity to the IMV and, in two cases, the marginal artery in the mesocolon of the colonic conduit. Surgeons reported high satisfaction with the use of ICG in vessel navigation.
Conclusion
ICG fluorescence imaging is a valuable tool for identifying critical vascular structures during minimally invasive colorectal surgery, improving surgical precision and decision-making, with high surgeon satisfaction. Further studies are needed to assess its impact on patient outcomes.