Robotic Heller-Dor procedure for oesophageal achalasia: Fluorescence-guided intraoperative assessment of myotomy. A retrospective single-centre experience.
fluorescence
fundoplication
indocyanine green
minimally invasive surgery
oesophageal achalasia
robotic surgery
Journal
The international journal of medical robotics + computer assisted surgery : MRCAS
ISSN: 1478-596X
Titre abrégé: Int J Med Robot
Pays: England
ID NLM: 101250764
Informations de publication
Date de publication:
Aug 2022
Aug 2022
Historique:
revised:
03
04
2022
received:
13
02
2022
accepted:
21
04
2022
pubmed:
27
4
2022
medline:
9
7
2022
entrez:
26
4
2022
Statut:
ppublish
Résumé
The robotic Heller-Dor (RHD) procedure for oesophageal achalasia (EA) is safe and effective. We aim to evaluate the intraoperative use of fluorescence imaging, as an alternative means to intraoperative endoscopy, to assess myotomy at the end of the procedure. Thirty-four patients affected with EA underwent RHD. The myotomy was assessed intraoperatively by endoscopy in group A (17 patients), and by fluorescence imaging in group B (17 patients). Perioperative and long-term results were compared. In group A, one mucosal tear was identified during intraoperative endoscopy. In group B, indocyanine green (ICG) helped identify residual muscle fibres in three cases. No perforation of the oesophageal mucosa occurred in group B. Fluorescence-imaging improved the identification of residual muscle fibres and made it possible to verify the integrity of the mucosa without the use of intraoperative endoscopy. A significant reduction in operative times has been related to the use of this technique.
Sections du résumé
BACKGROUND
BACKGROUND
The robotic Heller-Dor (RHD) procedure for oesophageal achalasia (EA) is safe and effective. We aim to evaluate the intraoperative use of fluorescence imaging, as an alternative means to intraoperative endoscopy, to assess myotomy at the end of the procedure.
METHODS
METHODS
Thirty-four patients affected with EA underwent RHD. The myotomy was assessed intraoperatively by endoscopy in group A (17 patients), and by fluorescence imaging in group B (17 patients). Perioperative and long-term results were compared.
RESULTS
RESULTS
In group A, one mucosal tear was identified during intraoperative endoscopy. In group B, indocyanine green (ICG) helped identify residual muscle fibres in three cases. No perforation of the oesophageal mucosa occurred in group B.
CONCLUSIONS
CONCLUSIONS
Fluorescence-imaging improved the identification of residual muscle fibres and made it possible to verify the integrity of the mucosa without the use of intraoperative endoscopy. A significant reduction in operative times has been related to the use of this technique.
Substances chimiques
Fluorescent Dyes
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e2411Informations de copyright
© 2022 John Wiley & Sons Ltd.
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