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- Title
Preclinical feasibility of robot‐assisted sentinel lymph node biopsy using multi‐modality magnetic and fluorescence guidance in the head and neck.
- Authors
Krishnan, Giri; Cousins, Aidan; Pham, Nguyen; Milanova, Valentina; Nelson, Melanie; Krishnan, Shridhar; van den Berg, Nynke S.; Shetty, Anil; Rosenthal, Eben L.; Wormald, Peter‐John; Thierry, Benjamin; Foreman, Andrew; Krishnan, Suren
- Abstract
Background: Sentinel lymph node biopsy (SLNB) is a staging procedure dependent on accurate mapping of draining lymphatics via tracers. Robot‐assisted SLNB enables access to multiple neck levels with a single incision and intraoperative fluorescence guidance to the SLN. Methods: Lymphatic mapping in swine was done using a magnetic tracer and fluorescent dye, injected into the tongue. MRI preoperatively mapped lymphatic spread of the magnetic tracer. Dissection was performed using a da Vinci Xi robot guided by fluorescence‐imaging of the dye. Results: Robot‐assisted SLNB was successfully performed in all animals (n = 5). A novel MRI protocol differentiated SLNs (n = 6) from lower echelon nodes (n = 11) based on flow progression. Fluorescence imaging provided valuable intraoperative guidance and correlated with magnetic‐positive nodes. Conclusions: This study demonstrates preclinical feasibility of a robot‐assisted approach to SLNB using magnetic and fluorescent tracers in the head and neck, enabling both preoperative mapping and intraoperative guidance.
- Subjects
SENTINEL lymph node biopsy; HEAD &; neck cancer; SURGICAL robots; FLUORESCENCE; FLUORESCENT dyes; NECK
- Publication
Head & Neck, 2022, Vol 44, Issue 12, p2696
- ISSN
1043-3074
- Publication type
Article
- DOI
10.1002/hed.27177