Robotic video endoscopic inguinal lymphadenectomy (R-VEIL) for vulvar cancer with sentinel node mapping using indocyanine green and near-infrared fluorescence imaging technology

Naldini, Angelica; Vizzielli, Giuseppe; Perrone, Emanuele; Gallotta, Valerio; Scambia, Giovanni

doi:10.1016/j.ygyno.2018.04.568

Cited by 10 publications

(6 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It is further used to define resection margins for oncological resections, but also resection planes for living donor liver transplantations [ 13 ]. Additional indications for the use of ICG are bleeding or perfusion control, i.e., in esophageal or colorectal surgery, and lymph node detection [ 13 , 52 , 53 , 54 , 55 ].…”

Section: Discussionmentioning

confidence: 99%

The Role of ICG in Robot-Assisted Liver Resections

Mehdorn

Richter

Heß

et al. 2022

JCM

View full text Add to dashboard Cite

Introduction: Robotic-assisted liver surgery (RALS) with its known limitations is gaining more importance. The fluorescent dye, indocyanine green (ICG), is a way to overcome some of these limitations. It accumulates in or around hepatic masses. The integrated near-infrared cameras help to visualize this accumulation. We aimed to compare the influence of ICG staining on the surgical and oncological outcomes in patients undergoing RALS. Material and Methods: Patients who underwent RALS between 2014 and 2021 at the Department of General Surgery at the University Hospital Schleswig-Holstein, Campus Kiel, were included. In 2019, ICG-supported RALS was introduced. Results: Fifty-four patients were included, with twenty-eight patients (50.9%) receiving preoperative ICG. Hepatocellular carcinoma (32.1%) was the main entity resected, followed by the metastasis of colorectal cancers (17%) and focal nodular hyperplasia (15.1%). ICG staining worked for different tumor entities, but diffuse staining was noted in patients with liver cirrhosis. However, ICG-supported RALS lasted shorter (142.7 ± 61.8 min vs. 246.4 ± 98.6 min, p < 0.001), tumors resected in the ICG cohort were significantly smaller (27.1 ± 25.0 mm vs. 47.6 ± 35.2 mm, p = 0.021) and more R0 resections were achieved by ICG-supported RALS (96.3% vs. 80.8%, p = 0.075). Conclusions: ICG-supported RALS achieve surgically and oncologically safe results, while overcoming the limitations of RALS.

show abstract

Section: Discussionmentioning

confidence: 99%

The Role of ICG in Robot-Assisted Liver Resections

Mehdorn

Richter

Heß

et al. 2022

JCM

View full text Add to dashboard Cite

show abstract

“…In one exploratory study, the imaging device was changed during the course of the study from SPY ® to PinPoint ® (32). In addition, few case reports have been published on feasibility and safety of robot-assisted SLN mapping with ICG in vulvar cancer patients (33,34). This minimally invasive approach might be a valid option to further reduce short-and long-term morbidity in these patients.…”

Section: Discussionmentioning

confidence: 99%

Exploratory Study of the Clinical Value of Near-Infrared Sentinel Lymph Node Mapping With Indocyanine Green in Vulvar Cancer Patients

et al. 2021

View full text Add to dashboard Cite

BackgroundThis study aimed to evaluate the clinical value of indocyanine green sentinel lymph node (SLN) mapping in patients with vulvar cancer. The conventional procedure of SLN mapping in vulvar cancer includes peritumoral injection of technetium-99m nanocolloid before surgery and intraoperative injection of a blue dye. However, these techniques harbor some limitations. Near-infrared fluorescence imaging with indocyanine green has gained popularity in SLN mapping in different types of cancer.MethodsWe analyzed retrospectively vulvar cancer patients at our institution between 2013 and 2020 undergoing indocyanine green SLN mapping by applying video telescope operating microscope system technology.Results64 groins of 34 patients were analyzed. In 53 groins we used technetium-99m nanocolloid, in four patent blue, and in five both techniques, additionally to indocyanine green for SLN detection. In total, 120 SLNs were identified and removed. The SLN detection rate of indocyanine green was comparable to technetium-99m nanocolloid (p=.143) and higher than patent blue (p=.003). The best results were achieved using a combination of ICG and technetium-99m nanocolloid (detection rate of 96.9%). SLN detection rates of indocyanine green were significantly higher in patients with positive lymph nodes (p=.035) and lymphatic space invasion (p=.004) compared to technetium-99m nanocolloid.ConclusionIndocyanine green SLN mapping in vulvar cancer is feasible and safe, with reasonable detection rates. Due to its easy application and few side effects, it offers a sound alternative to the conventional SLN mapping techniques in vulvar cancer. In patients with lymph node metastasis, indocyanine green even outperformed technetium-99m nanocolloid in terms of detection rate.

show abstract

“…in more than 95% of surgical procedures in different malignancies (head and neck, penile, melanoma and vulva) [11,14,17]. Several studies have been published concerning NIR fluorescence imaging using ICG or hybrid ICG-99m Tc-nanocolloid to detect SLNs in patients with VSCC [12][13][14][15][16]19,20,[23][24][25][26]. Most studies were feasibility studies or assessed the effect of different doses of ICG [13], optimal tracer formulation of ICG-99m Tc-nanocolloid [16,19], or explored the possibility of robotassisted SLN procedure using ICG [23,26].…”

Section: Discussionmentioning

confidence: 99%

Near-infrared fluorescence imaging compared to standard sentinel lymph node detection with blue dye in patients with vulvar cancer – a randomized controlled trial

Deken

Doorn

Verver

et al. 2020

Gynecologic Oncology

View full text Add to dashboard Cite

Near-infrared fluorescence imaging ICG-99m Tc-nanocolloid Indocyanine green Randomized controlled trial Objective. The aim of this study was to assess the superiority of ICG-99m Tc-nanocolloid for the intraoperative visual detection of sentinel lymph nodes (SLNs) in vulvar squamous cell carcinoma (VSCC) patients compared to standard SLN detection using 99m Tc-nanocolloid with blue dye. Methods. In this multicenter, randomized controlled trial, VSCC patients underwent either the standard SLN procedure or with the hybrid tracer ICG-99m Tc-nanocolloid. The primary endpoint was the percentage of fluorescent SLNs compared to blue SLNs. Secondary endpoints were successful SLN procedures, surgical outcomes and postoperative complications. Results. Forty-eight patients were randomized to the standard (n = 24) or fluorescence imaging group (n = 24) using ICG-99m Tc-nanocolloid. The percentage of blue SLNs was 65.3% compared to 92.5% fluorescent SLNs (p < 0.001). A successful SLN procedure was obtained in 92.1% of the groins in the standard group and 97.2% of the groins in the fluorescence imaging group (p = 0.33). Groups did not differ in surgical outcome, although more short-term postoperative complications were documented in the standard group (p = 0.041). Conclusions. Intraoperative visual detection of SLNs in patients with VSCC using ICG-99m Tc-nanocolloid was superior compared to 99m Tc-nanocolloid and blue dye. The rate of successful SLN procedures between both groups was not significantly different. Fluorescence imaging has potential to be used routinely in the SLN procedure in VSCC patients to facilitate the search by direct visualization. Clinical Trial Registration: Netherlands Trial Register (Trial ID NL7443).

show abstract

Robotic video endoscopic inguinal lymphadenectomy (R-VEIL) for vulvar cancer with sentinel node mapping using indocyanine green and near-infrared fluorescence imaging technology

Cited by 10 publications

References 4 publications

The Role of ICG in Robot-Assisted Liver Resections

The Role of ICG in Robot-Assisted Liver Resections

Exploratory Study of the Clinical Value of Near-Infrared Sentinel Lymph Node Mapping With Indocyanine Green in Vulvar Cancer Patients

Near-infrared fluorescence imaging compared to standard sentinel lymph node detection with blue dye in patients with vulvar cancer – a randomized controlled trial

Contact Info

Product

Resources

About