Use of video microsurgery platform in microsurgical subinguinal varicocelectomy with indocyanine green angiography

Abstract

Aim:The aim of the present study was to evaluate the feasibility of the use of the video microsurgery platform and fluorescence imaging exoscope system for microsurgical subinguinal varicocoelectomy (MSV) with intraoperative indocyanine green angiography (ICGA). Patients and Methods: Two patients with three varicoceles had MSV and intraoperative ICGA performed in August 2018. A video telescopic operating microscope (VITOM) 3-D system and a VITOM II ICG system were connected to a modular FULL HD IMAGE1 S camera platform. Both telescopes were mounted for convenient positioning and switch between the telescopes. Results: The VITOM 3-D system provided excellent, high-definition image quality and anatomical details necessary for the procedure of MSV. The system offered a more ergonomic working environment for the operating surgeons. The addition of VITOM II ICG system allowed intraoperative ICGA for better identification of the testicular artery. Testicular arteries were clearly identified and preserved. The setup with holding arms and a camera platform facilitated quick switch between the video systems. Conclusions: The procedure of MSV with intraoperative ICGA can be performed efficiently with the utilization of the video microsurgery platform.

Preliminary experience with indocyanine green lymphography during microsurgical subinguinal varicocelectomy

“…The procedures were performed under general anaesthesia with the patient in the supine position. Video microsurgery platform with VITOM 3‐D system (KARL STORZ SE, Tuttlingen, Germany) and VITOM II ICG system with SPIES camera (KARL STORZ SE, Germany) was installed as previously described 5 . MSV was performed under 3‐D optical magnification images on the television monitors.…”

“…Video microsurgery platform with VITOM 3-D system (KARL STORZ SE, Tuttlingen, Germany) and VITOM II ICG system with SPIES camera (KARL STORZ SE, Germany) was installed as previously described. 5 MSV was performed under 3-D optical magnification images on the television monitors. The testicle was delivered early in the procedure and gubernacular veins were controlled before meticulous dissection of the spermatic cord contents.…”

Microscopic subinguinal varicocelectomy with video telescopic operating microscope (VITOM) telescope: outcome analysis

“…The video exoscope system proved to be superior to standard operating microscope in terms of magnification, illumination and image quality when connected to ultra-high-definition monitors ( 8 ). In the setting of microscopic subinguinal varicocelectomy, the VITOM 2D and 3D model equipped with high-definition or 4K ultra-high-definition image quality and stereopsis-3D capability (magnification: < ×2, field of view: 50–150 mm, depth of field: 35–100 mm) provides excellent imaging and anatomical details, which allows for better identification of testicular artery necessary for the surgery ( 9 ).…”

Indocyanine green angiography and lymphography in microsurgical subinguinal varicocelectomy with evolving video microsurgery and fluorescence imaging platforms

“…The operations were performed under threedimensional (3D) optical magnification images on the television monitors using the video microsurgery platform with VITOM ® 3D system (KARL STORZ SE, Tuttlingen, Germany) as previously described. 2 A pack of 25 mg ICG (Diagnogreen; Daiichi Sankyo Co, Tokyo, Japan) was dissolved in 10 mL water. Identification of testicular arteries was assisted by ICG angiography with intravenous injection of 2 mL (5 mg) ICG solution.…”