First Experience with Fluorescence in Pediatric Laparoscopy
First Experience with Fluorescence in Pediatric Laparoscopy
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DOI：
10.1055/s-0039-1692191
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发表时间：
2019-01-01
影响因子：
0.6
通讯作者：
Carlos De Agustin, Juan
中科院分区：
文献类型：
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作者：
Fernandez-Bautista, Beatriz;Pelaez Mata, David;Carlos De Agustin, Juan
背景：最近，使用吲哚菁绿色（ICG）的术中荧光图像被描述为在成人外科手术过程中辅助决策。我们提出了我们的第一次经验，不同的腹腔镜程序进行儿童使用ICG荧光图像。材料与方法我们应用ICG荧光成像技术于精索静脉曲张结扎术、两肾切除术、胆囊切除术和1例冠状动脉瘘闭合术。所有手术均通过微创入路进行。使用了配备可见红外光源和灰度视觉技术的高清晰度摄像机。在腹腔镜手术前或期间注射ICG后，很容易准确识别血管解剖结构和胆管结构。荧光有助于评估来自精索血管的血流，确定肾血管化的变异性，并确定肾冠状动脉瘘的精确位置。ICG的胆汁排泄允许胆道的定义。结论在手术过程中，应用阿托伐他汀辅助图像可以清晰地显示解剖结构，并提供安全的手术操作。ICG成像系统似乎简单而安全。需要更大规模和更具体的研究来确认其适用性，扩大其适应症，并解决其优点和缺点。
Background The use of intraoperative fluorescence images with indocyanine green (ICG) has recently been described as an aid in decision-making during surgical procedures in adults. We present our first experiences with different laparoscopic procedures performed in children using ICG fluorescence images. Material and Method We have used ICG fluorescence imaging technique in varicocele ligation, two nephrectomies, cholecystectomy, and one case of aortocoronary fistula closure. All procedures were performed through a minimally invasive approach. A high definition camera equipped with a visible infrared light source and gray-scale vision technology was used. After injection of ICG before or during the laparoscopic procedure, precise identification of vascular anatomy and bile duct architecture were easily identified. Fluorescence helped to assess blood flow from the spermatic vessels, define the variability of renal vascularization, and determine the precise location of the aortocoronary fistula. Biliary excretion of the ICG allowed the definition of the biliary tract. Conclusion Fluorescein-assisted images allowed a clear definition of the anatomy and safe surgical maneuvers during surgical procedures. The ICG imaging system seems to be simple and safe. Larger and more specific studies are needed to confirm its applicability, expand its indications, and address its advantages and disadvantages.