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Near-infrared fluorescence tattooing: a new approach for endoscopic marking of tumors in minimally invasive colorectal surgery using a persistent near-infrared marker.
Thomaschewski, Michael; Lipp, Michael; Engelke, Carsten; Harder, Jonas; Labod, Isabell; Keck, Tobias; Mittmann, Karin.
Afiliação
  • Thomaschewski M; Department of Surgery, University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck, Germany.
  • Lipp M; Department of Surgery, Clinic for Gastrointestinal and Colorectal Surgery, Asklepios Klinik Barmbek, Hamburg, Germany.
  • Engelke C; Medical Clinic I, University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck, Germany.
  • Harder J; Department of Gastroenterology, Hepatology & Interventional Endoscopy, Asklepios Klinik Barmbek, Hamburg, Germany.
  • Labod I; EUREGIO BioMedtech Center, University of Applied Sciences Münster, Stegerwaldstr. 39, 48565, Steinfurt, Germany.
  • Keck T; Department of Surgery, University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck, Germany.
  • Mittmann K; EUREGIO BioMedtech Center, University of Applied Sciences Münster, Stegerwaldstr. 39, 48565, Steinfurt, Germany. mittmann@fh-muenster.de.
Surg Endosc ; 37(12): 9690-9697, 2023 12.
Article em En | MEDLINE | ID: mdl-37872429
ABSTRACT

INTRODUCTION:

Intraoperative accurate localization of tumors in the lower gastrointestinal tract is essential to ensure oncologic radicality. In minimally invasive colon surgery, tactile identification of tumors is challenging due to diminished or absent haptics. In clinical practice, preoperative endoscopic application of a blue dye (ink) to the tumor site has become the standard for marking and identification of tumors in the colon. However, this method has the major limitation that accidental intraperitoneal spillage of the dye can significantly complicate the identification of anatomical structures and surgical planes. In this work, we describe a new approach of NIR fluorescent tattooing using a near-infrared (NIR) fluorescent marker instead of a blue dye (ink) for endoscopic tattooing.

METHODS:

AFS81x is a newly developed NIR fluorescent marker. In an experimental study with four domestic pigs, the newly developed NIR fluorescent marker (AFS81x) was used for endoscopic tattooing of the colon. 7-12 endoscopic submucosal injections of AFS81x were placed per animal in the colon. On day 0, day 1, and day 10 after endoscopic tattooing with AFS81x, the visualization of the fluorescent markings in the colon was evaluated during laparoscopic surgery by two surgeons and photographically documented.

RESULTS:

The detection rate of the NIR fluorescent tattoos at day 0, day 1, and day 10 after endoscopic tattooing was 100%. Recognizability of anatomical structures during laparoscopy was not affected in any of the markings, as the markings were not visible in the white light channel of the laparoscope, but only in the NIR channel or in the overlay of the white light and the NIR channel of the laparoscope. The brightness, the sharpness, and size of the endoscopic tattoos did not change significantly on day 1 and day 10, but remained almost identical compared to day 0.

CONCLUSION:

The new approach of endoscopic NIR fluorescence tattooing using the newly developed NIR fluorescence marker AFS81x enables stable marking of colonic sites over a long period of at least 10 days without compromising the recognizability of anatomical structures and surgical planes in any way.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Tatuagem / Laparoscopia / Cirurgia Colorretal / Neoplasias do Colo Limite: Animals Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Tatuagem / Laparoscopia / Cirurgia Colorretal / Neoplasias do Colo Limite: Animals Idioma: En Ano de publicação: 2023 Tipo de documento: Article