We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Superselective intra-arterial hepatic injection of indocyanine green (ICG) for fluorescence image-guided segmental positive staining: experimental proof of the concept.
- Authors
Diana, Michele; Liu, Yu-Yin; Pop, Raoul; Kong, Seong-Ho; Legnèr, Andras; Beaujeux, Remy; Pessaux, Patrick; Soler, Luc; Mutter, Didier; Dallemagne, Bernard; Marescaux, Jacques
- Abstract
<bold>Background: </bold>Intraoperative liver segmentation can be obtained by means of percutaneous intra-portal injection of a fluorophore and illumination with a near-infrared light source. However, the percutaneous approach is challenging in the minimally invasive setting. We aimed to evaluate the feasibility of fluorescence liver segmentation by superselective intra-hepatic arterial injection of indocyanine green (ICG).<bold>Materials and Methods: </bold>Eight pigs (mean weight: 26.01 ± 5.21 kg) were involved. Procedures were performed in a hybrid experimental operative suite equipped with the Artis Zeego®, multiaxis robotic angiography system. A pneumoperitoneum was established and four laparoscopic ports were introduced. The celiac trunk was catheterized, and a microcatheter was advanced into different segmental hepatic artery branches. A near-infrared laparoscope (D-Light P, Karl Storz) was used to detect the fluorescent signal. To assess the correspondence between arterial-based fluorescence demarcation and liver volume, metallic markers were placed along the fluorescent border, followed by a 3D CT-scanning, after injecting intra-arterial radiological contrast (n = 3). To assess the correspondence between arterial and portal supplies, percutaneous intra-portal angiography and intra-arterial angiography were performed simultaneously (n = 1).<bold>Results: </bold>Bright fluorescence signal enhancing the demarcation of target segments was obtained from 0.1 mg/mL, in matter of seconds. Correspondence between the volume of hepatic segments and arterial territories was confirmed by CT angiography. Higher background fluorescence noise was found after positive staining by intra-portal ICG injection, due to parenchymal accumulation and porto-systemic shunting.<bold>Conclusions: </bold>Intra-hepatic arterial ICG injection, rapidly highlights hepatic target segment borders, with a better signal-to-background ratio as compared to portal vein injection, in the experimental setting.
- Subjects
INDOCYANINE green; CYANINES; LAPAROSCOPIC surgery; COMPUTER-assisted surgery; FLUOROPHORES; ANGIOGRAPHY; ANIMAL experimentation; DIAGNOSTIC imaging; DYES &; dyeing; HEPATIC artery; INTRA-arterial injections; LIVER; NONIONIZING radiation; INTRAOPERATIVE care; PORTAL vein; STAINS &; staining (Microscopy); SWINE; PILOT projects; INDOLE compounds; FLUORESCENT dyes
- Publication
Surgical Endoscopy & Other Interventional Techniques, 2017, Vol 31, Issue 3, p1451
- ISSN
1866-6817
- Publication type
journal article
- DOI
10.1007/s00464-016-5136-y