The Utility of Near-Infrared Fluorescence and Indocyanine Green During Robotic Pulmonary Resection

Ferrari-Light, Dana; Geraci, Travis C.; Sasankan, Prabhu; Cerfolio, Robert J.

doi:10.3389/fsurg.2019.00047

Cited by 20 publications

(10 citation statements)

References 25 publications

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“…La implementación de la mínima invasión en la cirugía torácica ha permitido expandir las resecciones pulmona res mayores con menor morbilidad. A su vez, la capaci dad táctil del cirujano se distorsiona, por lo debe optimizarse la visualización del campo quirúrgico [4].…”

Section: Discussionunclassified

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Localización preoperatoria guiada por tomografía computada de nódulo pulmonar con verde de indocianina para resección toracoscópica uniportal asistida por robot. Reporte de caso

et al. 2022

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Introducción: El abordaje del nódulo pulmonar solitario tiene como objetivo la detección temprana del cáncer de pulmón en donde la resección quirúrgica es la piedra angular del tratamiento. La tecnología de imagen por fluorescencia combina un agente excitable en el espectro de luz cercano al infrarrojo y un sistema para visualizar selectivamente un tejido diana que permite su localización intraoperatoria. Caso clínico: Varón de 72 años fumador con un nódulo pulmonar de 9 milímetros con patrón en vidrio deslustrado en el lóbulo inferior derecho localizado bajo guía tomográfica con verde de indocianina y tratado mediante resección sublobar con linfadenectomía sistemática asistida por robot con abordaje uniportal. Conclusión: La técnica de marcaje preoperatorio con verde de indocianina y tecnología de imagen por fluorescencia es un método seguro y preciso que permite la identificación intraoperatoria de un nódulo pulmonar solitario durante la cirugía de mínima invasión.

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Section: Discussionunclassified

“…El uso global de la tomografía computada de alta resolu ción y los estudios de cribado en pacientes de alto riesgo representan las principales causas en el incremento de la detección de nódulos subcentimétricos y con característi cas de GGO que pueden ameritar un diagnóstico patoló gico [4].…”

Section: Discussionunclassified

Localización preoperatoria guiada por tomografía computada de nódulo pulmonar con verde de indocianina para resección toracoscópica uniportal asistida por robot. Reporte de caso

et al. 2022

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“…Using ENB and ICG fluorescence for pulmonary tumor localization requires well-trained physicians and depends heavily on the equipment. In addition, it is difficult to localize nodules located in the upper lobes and at peripheral sites using bronchoscopy (20).…”

Section: Discussionmentioning

confidence: 99%

Watershed analysis of the target pulmonary artery for real-time localization of non-palpable pulmonary nodules

Chu

Chen

Lin

et al. 2021

Transl Lung Cancer Res

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Background: Some pulmonary nodules are not suitable for computed tomography-guided percutaneous localization. This study aimed to investigate the feasibility and safety of real-time localization for these nonpalpable pulmonary nodules using watershed analysis of the target pulmonary artery during thoracoscopic wedge resection.Methods: Watershed analysis is a novel technique that can be used to create a specific area on the lung surface for nodule localization. This analysis is performed by temporarily blocking the target pulmonary artery and using indocyanine green fluorescence during surgery. In our study, the surgery was simulated and evaluated preoperatively using a high-precision three-dimensional reconstruction model obtained by multidetector spiral computed tomography. The lung was observed using an infrared thoracoscopy system after an intravenous injection of indocyanine green (2.5 mg/mL), and the white-to-blue transitional zone was marked using electrocautery, after which a wedge resection was performed.Results: A total of 25 out of 26 patients underwent successful wedge resection. The mean tumor size and depth based on computed tomography scans were 13.2±6.4 and 12.2±7.8 mm, respectively. The mean operation duration was 142.6±52.8 min. The mean bleeding volume during surgery was 12.9±9.7 mL. The mean drainage tube indwelling time was 35.6±20.0 h, and the median length of postoperative stay was 3 days (range, 2-6 days).Conclusions: Our experience showed that the watershed analysis of the target pulmonary artery for nodule localization was safe and feasible. It may become an effective and attractive alternative method for localizing non-palpable pulmonary nodules in selected patients undergoing thoracoscopic wedge resection.

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“…Despite a number of narrative reviews highlighting the usefulness of indocyanine green (ICG) in thoracic surgery, its true value remains equivocal ( 12 – 14 ). For that reason, we conducted a systematic review of the literature that would investigate the effectiveness and safety of ICG in detection of malignant lung nodules.…”

Section: Introductionmentioning

confidence: 99%

How effective is indocyanine green (ICG) in localization of malignant pulmonary nodules? A systematic review and meta-analysis

et al. 2022

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BackgroundVideo-Assisted and Robotic-Assisted techniques become constantly more prominent practice in thoracic surgery for lung cancer. Furthermore, the increased frequency in detection of small lung cancers makes the intra-operative identification of these cancers even more challenging. Indocyanine Green (ICG) is one of the most commonly used dyes that assists surgeons identify small lung cancers intra-operatively. Our study aimed to evaluate the effectiveness and safety of ICG in lung cancer detection.MethodsWe performed a systematic review of the literature by screening the databases of MEDLINE, EMBASE, CENTRAL and Scopus until 30th April 2022 and the first 300 articles of Google Scholar for any suitable grey literature. We included any study that investigated the effectiveness of ICG in lung cancer detection. We excluded studies that explored the use of ICG only in identification of intersegmental planes, lymph node mapping, case reports and non-English articles. We aimed to perform a meta-analysis on test accuracy studies using hierarchical summary receiver operating characteristic (HSROC) and the bivariate random-effects models. In cases where the data for a localization technique was not sufficient for that analysis, it was presented with tables with narrative purposes. Each study was assessed for Risk of Bias (RoB) and Applicability using the QUADAS-2 tool.ResultsWe found 30 eligible studies that included a total of 1,776 patients who underwent ICG localization of pulmonary nodules. We identified three ICG localization techniques: CT-guided, endobronchial and intravenous. From the 30 studies, 13 investigated CT-guided localization, 12 explored an endobronchial method while 8 studies administered ICG intravenously the median reported success rate was 94.3% (IQR: 91.4%–100%) and 98.3% (IQR: 94%–100%) for the first two techniques respectively. Intravenous ICG lung cancer localization showed Sensitivity of 88% (95% CI: 59%–0.97%) and Specificity of 25% (95% CI: 0.04%–0.74%). There were 15.2% (150/989) patients who experienced complications from CT guided ICG localization. No ICG-related complications were reported in endobronchial or intravenous techniques.ConclusionOur study provides a comprehensive review of the literature on ICG localization techniques for lung cancer. Current evidence suggests that ICG is boh effective and safe. Further prospective research with standardized protocols across multiple thoracic units is required in order to accurately validate these findings.

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The Utility of Near-Infrared Fluorescence and Indocyanine Green During Robotic Pulmonary Resection

Cited by 20 publications

References 25 publications

Localización preoperatoria guiada por tomografía computada de nódulo pulmonar con verde de indocianina para resección toracoscópica uniportal asistida por robot. Reporte de caso

Localización preoperatoria guiada por tomografía computada de nódulo pulmonar con verde de indocianina para resección toracoscópica uniportal asistida por robot. Reporte de caso

Watershed analysis of the target pulmonary artery for real-time localization of non-palpable pulmonary nodules

How effective is indocyanine green (ICG) in localization of malignant pulmonary nodules? A systematic review and meta-analysis

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