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Multispectral Imaging Using Fluorescent Properties of Indocyanine Green and Methylene Blue in Colorectal Surgery—Initial Experience
Abstract
Introduction: Image-guided surgery is becoming a new tool in colorectal surgery. Intraoperative visualisation of different structures using fluorophores helps during various steps of operations. In our report, we used two fluorophores—indocyanine green (ICG), and methylene blue (MB)— during different steps of colorectal surgery, using one camera system for two separate near-infrared wavelengths. Material and methods: Twelve patients who underwent complex open or laparoscopic colorectal surgeries were enrolled. Intravenous injections of MB and ICG at different time points were administered. Visualisation of intraoperative ureter position and fluorescent angiography for optimal anastomosis was performed. A retrospective analysis of patients treated in our departments during 2020 was performed, and data about ureter injury and anastomotic site complications were collected. Results: Intraoperative localisation of ureters with MB under fluorescent light was possible in 11 patients. The mean signal-to-background ratio was 1.58 0.71. Fluorescent angiography before performing anastomosis using ICG was successful in all 12 patients, and none required a change in position of the planned colon resection for anastomosis. The median signal-to-background ratios was 1.25 (IQR: 1.22–1.89). Across both centres, iatrogenic injury of the ureter was found in 0.4% of cases, and complications associated with anastomosis was found in 5.5% of cases. Conclusions: Our study showed a substantial opportunity for using two different fluorophores in colorectal surgery, whereby the visualisation of one will not change the possible quantification analysis of the other. Using two separate dyes during one procedure may help in optimisation of the fluorescent properties of both dyes when using them for different applications. Visualisation of different structures by different fluorophores seems to be the future of image-guided surgery, and shows progress in optical technologies used in image-guided surgery.
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Authors (9)
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Wojciech Polom
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Marcin Migaczewski
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Jaroslaw Skokowski
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Maciej Swierblewski
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Tomasz Cwalinski
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Michal Pedziwiatr
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Marcin Matuszewski
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Karol Polom
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Full text
- Publication version
- Accepted or Published Version
- DOI:
- Digital Object Identifier (open in new tab) 10.3390/jcm11020368
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- Category:
- Articles
- Type:
- artykuły w czasopismach
- Published in:
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Journal of Clinical Medicine
no. 11,
ISSN: 2077-0383 - Language:
- English
- Publication year:
- 2022
- Bibliographic description:
- Polom W., Migaczewski M., Skokowski J., Swierblewski M., Cwalinski T., Kalinowski L., Pedziwiatr M., Matuszewski M., Polom K.: Multispectral Imaging Using Fluorescent Properties of Indocyanine Green and Methylene Blue in Colorectal Surgery—Initial Experience// Journal of Clinical Medicine -Vol. 11,iss. 2 (2022), s.368-
- DOI:
- Digital Object Identifier (open in new tab) 10.3390/jcm11020368
- Sources of funding:
-
- Free publication
- Verified by:
- Gdańsk University of Technology
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