Near-Infrared Fluorescence Laparoscopy of the Cystic Duct and Artery in Pigs: Performance of a Preclinical Dye

Abstract

Take-down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim.Downloaded from the University of Groningen/UMCG research database (Pure): http://www.rug.nl/research/portal. For technical reasons the number of authors shown on this cover page is limited to 10 maximum. Background: Near-infrared fluorescence laparoscopy after intravenous indocyanine green (ICG) administration has been proposed as a promising surgical imaging technique for real-time visualization of the extrahepatic bile ducts and arteries in clinical laparoscopic cholecystectomies. However, optimization of this new technique with respect to the imaging system combined with the fluorophore is desirable. The performance of a preclinical near-infrared dye, CW800-CA, was compared with that of ICG for near-infrared fluorescence laparoscopy of the cystic duct and artery in pigs. Materials and Methods: Laparoscopic cholecystectomy was performed in six pigs (average weight, 35 kg) using a commercially available laparoscopic fluorescence imaging system. The fluorophores CW800-CA and ICG (both 800 nm fluorescent dyes) were administered by intravenous injection in four and two pigs, respectively. CW800-CA was administered in three different doses (consecutively 0.25, 1, and 3 mg); ICG was intravenously injected (2.5 mg) for comparison. Intraoperative recognition of the biliary structures was recorded at set time points. The target-to-background ratio was determined to quantify the fluorescence signal of the designated tissues.

Accuracy of Near Infrared-Guided Surgery in Morbidly Obese Subjects Undergoing Laparoscopic Cholecystectomy

“…Similar results by Schols et al [10] stated that fluorescence imaging did not prolong surgery length and can be performed at any point during LC.…”

“…The chief drawbacks of laparoscopy compared to open surgery are the lack of three-dimensional visualization and tactile feedback that may result in misinterpretation [7]. In recent years, a technique of using near infrared light and a fluorescent dye to visualize tumors and structures with minimal dissection has gained recognition [8][9][10][11][12]. Literature supported more than 90 % detection of extrahepatic biliary ducts in laparoscopic cholecystectomies (LC) by this imaging method [13].…”

Characterizing the Utility and Limitations of Repurposing an Open-Field Optical Imaging Device for Fluorescence-Guided Surgery in Head and Neck Cancer Patients

“…As such, exploring the feasibility of using a single device, especially those that are already commercially available, to image multiple probes is of current interest to many investigators in the field. Schols et al applied a commercially available NIR laparoscopic imaging device designed for use with indocyanine green to image biliary anatomy using IRDye800CW in pigs (27). We have demonstrated that the limited wavelength overlap was not a deterrent to successful tumor identification or delineation as confirmed by histology.…”

Image-guided surgery

“…Indeed, false positive lesions have been reported, notably in hepatibiliary surgery field. 137,138 Recently, Schols and colleagues 167 have reported interesting results using a new NIR dye (CW800-CA) showing the same characteristics as ICG. They found that fluorescent cholangiography of the cystic duct could be obtained earlier ( À 10 minutes) with the new dye in comparison to ICG.…”