A novel endoscopic fluorescent clip visible with near-infrared imaging during laparoscopic surgery in a porcine model
A novel endoscopic fluorescent clip visible with near-infrared imaging during laparoscopic surgery in a porcine model
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DOI：
10.1007/s00464-014-3423-z
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发表时间：
2014-06-01
影响因子：
3.1
通讯作者：
Mori, Masaki
中科院分区：
文献类型：
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作者：
Takeyama, Hiroshi;Hata, Taishi;Mori, Masaki
在胃肠道肿瘤手术中，特别是在早期癌症中，准确的肿瘤定位对于确定切除的范围是很重要的。在腹腔镜手术中，由于无法触诊病变，最普遍的定位方法是内窥镜纹身。但由于操作复杂，难以控制染料局部扩散和染料渗漏到腹腔内。需要一种更简单、更安全的方法。在这项研究中，我们开发了一种在腹腔镜手术中应用荧光涂层内窥镜夹来可视化结肠内位置的新方法。我们在体内猪模型和离体人结肠组织中测试了该程序。将牛血清白蛋白与吲哚菁绿或琥珀酰酯CF (TM) 790偶联形成糊状混合物，用于涂覆内镜夹前端。在内窥镜下，将荧光涂层夹置于猪结肠粘膜表面。使用奥林巴斯近红外腹腔镜系统，我们试图在活体腹腔镜手术中识别猪结肠外浆膜侧的荧光夹。这些片段也用离体人结肠组织进行了评估。在猪结肠内粘膜表面放置两个夹子后，在活体腹腔镜手术中，我们使用近红外腹腔镜从结肠外浆膜表面实时观察它们。我们还在离体研究中通过人类结肠组织鉴定了荧光涂层夹。我们开发了一种新型的荧光涂层夹，可以在内窥镜下快速准确地定位结肠病变。在猪模型和离体人结肠组织的腹腔镜手术中，利用近红外荧光成像成功地观察到了这些片段。
In gastrointestinal cancer surgery, particularly in early cancer, accurate tumor localization is important in order to determine the extent of resection. In laparoscopic surgery, because of the inability to palpate the lesion, the most prevalent method of localization is endoscopic tattooing. However, complicated maneuvering makes it difficult to control local dye spreading and dye leakage into the intraperitoneal cavity. A simpler, safe method is needed. In this study, we developed a novel method for applying fluorescence-coated endoscopic clips to visualize locations inside the colon during laparoscopic surgery. We tested the procedure in an in vivo porcine model and with ex vivo human colon tissues.Bovine serum albumin was conjugated to indocyanine green or the succinimidyl ester CF (TM) 790 to form a pasty mixture, which was used to coat the front ends of endoscopic clips. The fluorescence-coated clips were endoscopically placed on the mucosal surface of a porcine colon. Using an Olympus near-infrared laparoscopy system, we attempted to identify the fluorescent clips from the outer, serosal side of the porcine colon during laparoscopic surgery in vivo. The clips were also evaluated using ex vivo human colon tissues.After placing two clips on the inner, mucosal surface of the porcine colon, we used near-infrared laparoscopy to view them from the outer, serosal surface of the colon in real time during in vivo laparoscopic surgery. We also identified the fluorescence-coated clips through human colon tissues in an ex vivo study.We developed a novel, fluorescence-coated clip that can be placed endoscopically for rapid, exact localization of colonic lesions. The clips were successfully visualized with near-infrared fluorescence imaging during laparoscopic surgery in an in vivo porcine model and in ex vivo human colon tissues.