A novel method for near-infrared fluorescence imaging of the urethra during perineal and transanal surgery: demonstration in a cadaveric model.
Fluorescene imaging
colorectal cancer
fluorescence imaging guided surgery
near-infrared
transanal surgery
urethra injury
Journal
Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland
ISSN: 1463-1318
Titre abrégé: Colorectal Dis
Pays: England
ID NLM: 100883611
Informations de publication
Date de publication:
11 2020
11 2020
Historique:
received:
20
04
2020
accepted:
04
05
2020
pubmed:
23
5
2020
medline:
19
8
2021
entrez:
23
5
2020
Statut:
ppublish
Résumé
Transanal total mesorectal excision is a promising novel sphincter-saving procedure for low rectal cancer. However, the transanal bottom-up dissection is associated with increased rates of iatrogenic urethral injuries. Near-infrared fluorescence (NIRF) imaging, given its deeper tissue penetration, has been explored in a limited number of studies for enhanced intra-operative urethral visualization. In this study, we explored the feasibility of a novel, ultrabright, biocompatible fluorescent polymer to coat urinary catheters for the purpose of intra-operative urethral visualization. In an ex vivo experiment, using a near-infrared laparoscope, the fluorescent signal of a coated catheter (near-infrared coating of equipment, NICE) was qualitatively and quantitatively compared to the signal of indocyanine green (ICG)/Instillagel® mixtures and ICG-filled catheters at several concentrations. Also, in three male human torsos, using fluorescent urinary catheters, NIRF-guided perineal dissections and a transanal total mesorectal excision were performed. Intra-operative NIRF-based urethral visualization was performed systematically. During the qualitative and quantitative fluorescence signal assessment, NICE-coated catheters were clearly superior to the ICG-based solutions. In the cadaveric experiments, enhanced urethral visualization was possible even at early stages of dissection, when the organ was covered by several tissue layers. NICE-coated catheters represent a promising potential to allow for NIRF-based intra-operative urethral visualization.
Substances chimiques
Indocyanine Green
IX6J1063HV
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1749-1753Subventions
Organisme : Fondation ARC pour la Recherche sur le Cancer
Organisme : SATT Connectus
ID : NICE
Informations de copyright
Colorectal Disease © 2020 The Association of Coloproctology of Great Britain and Ireland.
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