Usability of Indocyanine Green in Robot-Assisted Hepatic Surgery
Recent developments in robotic surgery have led to an increasing number of robot-assisted hepatobiliary procedures. However, a limitation of robotic surgery is the missing haptic feedback. The fluorescent dye indocyanine green (ICG) may help in this context, which accumulates in hepatocellular cance...
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doaj-a806c5a89c074c74935f89895c463b1b2021-01-26T00:04:18ZengMDPI AGJournal of Clinical Medicine2077-03832021-01-011045645610.3390/jcm10030456Usability of Indocyanine Green in Robot-Assisted Hepatic SurgeryAnne-Sophie Mehdorn0Jan Henrik Beckmann1Felix Braun2Thomas Becker3Jan-Hendrik Egberts4Deptpartment Of General, Abdominal, Thoracic, Transplantation and Pediatric Surgery, Campus Kiel, University Hospital Schleswig-Holstein, Arnold-Heller-Straße 3, 24105 Kiel, GermanyDeptpartment Of General, Abdominal, Thoracic, Transplantation and Pediatric Surgery, Campus Kiel, University Hospital Schleswig-Holstein, Arnold-Heller-Straße 3, 24105 Kiel, GermanyDeptpartment Of General, Abdominal, Thoracic, Transplantation and Pediatric Surgery, Campus Kiel, University Hospital Schleswig-Holstein, Arnold-Heller-Straße 3, 24105 Kiel, GermanyDeptpartment Of General, Abdominal, Thoracic, Transplantation and Pediatric Surgery, Campus Kiel, University Hospital Schleswig-Holstein, Arnold-Heller-Straße 3, 24105 Kiel, GermanyDeptpartment Of General, Abdominal, Thoracic, Transplantation and Pediatric Surgery, Campus Kiel, University Hospital Schleswig-Holstein, Arnold-Heller-Straße 3, 24105 Kiel, GermanyRecent developments in robotic surgery have led to an increasing number of robot-assisted hepatobiliary procedures. However, a limitation of robotic surgery is the missing haptic feedback. The fluorescent dye indocyanine green (ICG) may help in this context, which accumulates in hepatocellular cancers and around hepatic metastasis. ICG accumulation may be visualized by a near-infrared camera integrated into some robotic systems, helping to perform surgery more accurately. We aimed to test the feasibility of preoperative ICG application and its intraoperative use in patients suffering from hepatocellular carcinoma and metastasis of colorectal cancer, but also of other origins. In a single-arm, single-center feasibility study, we tested preoperative ICG application and its intraoperative use in patients undergoing robot-assisted hepatic resections. Twenty patients were included in the final analysis. ICG staining helped in most cases by detecting a clear lesion or additional metastases or when performing an R0 resection. However, it has limitations if applied too late before surgery and in patients suffering from severe liver cirrhosis. ICG staining may serve as a beneficial intraoperative aid in patients undergoing robot-assisted hepatic surgery. Dose and time of application and standardized fluorescence intensity need to be further determined.https://www.mdpi.com/2077-0383/10/3/456robotic surgeryindocyanine greenrobotic liver resectionda Vinciintraoperative imaginghepatocellular cancer |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Anne-Sophie Mehdorn Jan Henrik Beckmann Felix Braun Thomas Becker Jan-Hendrik Egberts |
spellingShingle |
Anne-Sophie Mehdorn Jan Henrik Beckmann Felix Braun Thomas Becker Jan-Hendrik Egberts Usability of Indocyanine Green in Robot-Assisted Hepatic Surgery Journal of Clinical Medicine robotic surgery indocyanine green robotic liver resection da Vinci intraoperative imaging hepatocellular cancer |
author_facet |
Anne-Sophie Mehdorn Jan Henrik Beckmann Felix Braun Thomas Becker Jan-Hendrik Egberts |
author_sort |
Anne-Sophie Mehdorn |
title |
Usability of Indocyanine Green in Robot-Assisted Hepatic Surgery |
title_short |
Usability of Indocyanine Green in Robot-Assisted Hepatic Surgery |
title_full |
Usability of Indocyanine Green in Robot-Assisted Hepatic Surgery |
title_fullStr |
Usability of Indocyanine Green in Robot-Assisted Hepatic Surgery |
title_full_unstemmed |
Usability of Indocyanine Green in Robot-Assisted Hepatic Surgery |
title_sort |
usability of indocyanine green in robot-assisted hepatic surgery |
publisher |
MDPI AG |
series |
Journal of Clinical Medicine |
issn |
2077-0383 |
publishDate |
2021-01-01 |
description |
Recent developments in robotic surgery have led to an increasing number of robot-assisted hepatobiliary procedures. However, a limitation of robotic surgery is the missing haptic feedback. The fluorescent dye indocyanine green (ICG) may help in this context, which accumulates in hepatocellular cancers and around hepatic metastasis. ICG accumulation may be visualized by a near-infrared camera integrated into some robotic systems, helping to perform surgery more accurately. We aimed to test the feasibility of preoperative ICG application and its intraoperative use in patients suffering from hepatocellular carcinoma and metastasis of colorectal cancer, but also of other origins. In a single-arm, single-center feasibility study, we tested preoperative ICG application and its intraoperative use in patients undergoing robot-assisted hepatic resections. Twenty patients were included in the final analysis. ICG staining helped in most cases by detecting a clear lesion or additional metastases or when performing an R0 resection. However, it has limitations if applied too late before surgery and in patients suffering from severe liver cirrhosis. ICG staining may serve as a beneficial intraoperative aid in patients undergoing robot-assisted hepatic surgery. Dose and time of application and standardized fluorescence intensity need to be further determined. |
topic |
robotic surgery indocyanine green robotic liver resection da Vinci intraoperative imaging hepatocellular cancer |
url |
https://www.mdpi.com/2077-0383/10/3/456 |
work_keys_str_mv |
AT annesophiemehdorn usabilityofindocyaninegreeninrobotassistedhepaticsurgery AT janhenrikbeckmann usabilityofindocyaninegreeninrobotassistedhepaticsurgery AT felixbraun usabilityofindocyaninegreeninrobotassistedhepaticsurgery AT thomasbecker usabilityofindocyaninegreeninrobotassistedhepaticsurgery AT janhendrikegberts usabilityofindocyaninegreeninrobotassistedhepaticsurgery |
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