Fluorescence-Guided Thoracic Duct Dissection in Robotic en Bloc Esophagectomy

Jardinet, Thomas; Niekel, Maarten; Ruppert, Martin; Hubens, Guy; Valk, Jody; Schil, Paul Van; Maat, Michiel F. de

doi:10.1016/j.athoracsur.2021.08.034

Cited by 6 publications

(3 citation statements)

References 6 publications

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“…Jardinet et al successfully applied these techniques in robotic-assisted esophagectomy by inserting an intra-lymphatic needle in an inguinal node and injecting ICG after mobilization of the inferior pulmonary ligament. This not only identified the thoracic duct, but did so with less time for set-up, more rapid fluorescence, and longer signal duration, as compared to prior studies that did not utilize the robotic platform (46). Similarly, Barbato et al and Varshney et al both utilized ICG in 18 and 21 patients, respectively, with identification of the thoracic duct in all patients in the robotic setting (47,48).…”

Section: Identification Of Anatomymentioning

confidence: 93%

“…The robotic platform for MIE has the potential to reduce the morbidity and mortality of esophagectomy in several ways, including use of additional built-in diagnostic tools such as intraoperative fluorescence imaging. When considering the use of adjunct tools, the technical advantages of a robotic-assisted platform cannot be understated as improved optics, scaling, and built-in fluorescence camera for rapid angiography allows for a more precise and tailored dissection, and provides quantifiable metrics to define optimal perfusion of the conduit and anastomosis (22,25,38,46) (Figures 1,2). Firefly represents an integrated fluorescent camera which is now standard equipment in all da Vinci Surgical Systems, and includes cameras modified for NIR light, filters and sensors for ICG, and light emitting diode (LED)-based illuminators with a NIR laser to excite ICG (49).…”

Section: Advantages In Robotic-assisted Esophagectomymentioning

confidence: 99%

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Intraoperative fluorescence imaging in esophagectomy and its application to the robotic platform: a narrative review

Papageorge¹,

Sachdeva²,

Schumacher³

2022

J Thorac Dis

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Background and Objective: Robotic-assisted esophagectomy is an approach to minimally invasive esophagectomy (MIE) that has demonstrated equivalent or improved outcomes relative to open and other minimally invasive techniques. The robotic approach also allows unique opportunities to improve complications following esophagectomy through use of enhanced visualization tools, including intraoperative fluorescence imaging. In this review, we summarize the specific uses of intraoperative fluorescence imaging as an adjunct tool during esophagectomy and discuss its application to the robotic platform.

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Section: Identification Of Anatomymentioning

confidence: 93%

Section: Advantages In Robotic-assisted Esophagectomymentioning

confidence: 99%

Intraoperative fluorescence imaging in esophagectomy and its application to the robotic platform: a narrative review

Papageorge¹,

Sachdeva²,

Schumacher³

2022

J Thorac Dis

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“…Jardinet et al [ 72 ] described a technique to facilitate thoracic duct identification and ligation control when required during robot-assisted esophagectomy. Lymphangiography-guided injection of indocyanine green into the right groin of a patient in the left-lateral position.…”

Section: The Uses Of Icg In Traumamentioning

confidence: 99%

Application of indocyanine green in surgery: A review of current evidence and implementation in trauma patients

Abdelrahman¹,

El‐Menyar²,

Peralta³

et al. 2023

World J Gastrointest Surg

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Background: Modern surgical medicine strives to manage trauma while improving outcomes using functional imaging. Identification of viable tissues is crucial for the surgical management of polytrauma and burn patients presenting with soft tissue and hollow viscus injuries. Bowel anastomosis after trauma-related resection is associated with a high rate of leakage. The ability of the surgeon’s bare eye to determine bowel viability remains limited, and the need for a more standardized objective assessment has not yet been fulfilled. Hence, there is a need for more precise diagnostic tools to enhance surgical evaluation and visualization to aid early diagnosis and timely management to minimize trauma-associated complications. Indocyanine green (ICG) coupled with fluorescence angiography is a potential solution for this problem. ICG is a fluorescent dye that responds to near-infrared irradiation. Methods: We conducted a narrative review to address the utility of ICG in the surgical management of patients with trauma as well as elective surgery. Discussion: ICG has many applications in different medical fields and has recently become an important clinical indicator for surgical guidance. However, there is a paucity of information regarding the use of this technology to treat traumas. Recently, angiography with ICG has been introduced in clinical practice to visualize and quantify organ perfusion under several conditions, leading to fewer cases of anastomotic insufficiency. This has great potential to bridge this gap and enhance the clinical outcomes of surgery and patient safety. However, there is no consensus on the ideal dose, time, and manner of administration nor the indications that ICG provides a genuine advantage through greater safety in trauma surgical settings. Conclusions: There is a scarcity of publications describing the use of ICG in trauma patients as a potentially useful strategy to facilitate intraoperative decisions and to limit the extent of surgical resection. This review will improve our understanding of the utility of intraoperative ICG fluorescence in guiding and assisting trauma surgeons to deal with the intraoperative challenges and thus improve the patients’ operative care and safety in the field of trauma surgery.

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Esophagectomy—prevention of complications-tips and tricks for the preoperative, intraoperative and postoperative stage

Romario

Pascale

2022

Updates Surg

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Fluorescence-Guided Thoracic Duct Dissection in Robotic en Bloc Esophagectomy

Cited by 6 publications

References 6 publications

Intraoperative fluorescence imaging in esophagectomy and its application to the robotic platform: a narrative review

Intraoperative fluorescence imaging in esophagectomy and its application to the robotic platform: a narrative review

Application of indocyanine green in surgery: A review of current evidence and implementation in trauma patients

Esophagectomy—prevention of complications-tips and tricks for the preoperative, intraoperative and postoperative stage

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