Intra‐operative visualization of the ureter by near‐infrared fluorescence during robotic‐assisted laparoscopic sigmoidectomy for diverticulitis – a video vignette

2019 ◽  
Vol 22 (3) ◽  
pp. 354-355
Author(s):  
F. Khan ◽  
R. Keenan ◽  
A. Keyes ◽  
R. A. Cahill
Keyword(s):  
Near Infrared ◽  
Near Infrared Fluorescence ◽  
Laparoscopic Sigmoidectomy ◽  
Robotic Assisted ◽  
Video Vignette

scholarly journals Intraoperative Near-Infrared Fluorescence Imaging as an Adjunct to Robotic-Assisted Minimally Invasive Esophagectomy

2014 ◽  
Vol 9 (5) ◽  
pp. 391-393 ◽  
Author(s):  
Inderpal S. Sarkaria ◽  
Manjit S. Bains ◽  
David J. Finley ◽  
Prasad S. Adusumilli ◽  
James Huang ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Indocyanine Green ◽  
Fluorescence Imaging ◽  
Near Infrared ◽  
Minimally Invasive Esophagectomy ◽  
Near Infrared Fluorescence ◽  
Robotic Assisted ◽  
Invasive Esophagectomy ◽  
Vascular Arcade ◽  
Near Infrared Fluorescence Imaging

During esophagectomy, identification and preservation of the right gastroepiploic vascular arcade are critical and may be challenging with minimally invasive approaches. We assessed the use of near-infrared fluorescence imaging fluorescence angiography (NIFI-FA) during robotic-assisted minimally invasive esophagectomy (RAMIE) as an aid to visualize the gastric vasculature with mobilization. After intravenous administration of 10 mg of indocyanine green, a robotic platform with near-infrared optical fluorescence capability was used to examine the gastric vasculature in patients undergoing RAMIE. Thirty (71%) of 42 patients undergoing RAMIE were assessed using NIFI-FA during mobilization of the greater gastric curve and fundus; 11 were excluded because the system was not available, and 1 was excluded because of documented allergy to iodinated contrast. The median time from indocyanine green administration to detectable fluorescence was 37.5 seconds (range, 20–105 seconds). Near-infrared fluorescence imaging FA identified or confirmed termination of the vascular arcade in all 30 cases. Subjectively, NIFI-FA often identified otherwise unvisualized small transverse vessels between the termination of the vascular arcade and the first short gastric artery, as well as between the short gastric arteries. Identification and/or confirmation of the vascular arcade position during mobilization of the greater curve/omentum were also aided by NIFI-FA. Although there are limitations to the current technology, NIFI-FA may be a useful adjunct to confirm and identify the position of gastroepiploic vessels, allow for safer and more confident dissections during gastric mobilization, as well as potentially decrease serious intraoperative vascular misadventures.

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