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Multispectral Imaging Using Fluorescent Properties of Indocyanine Green and Methylene Blue in Colorectal Surgery—Initial Experience

Introduction: Image-guided surgery is becoming a new tool in colorectal surgery. Intraoperative visualisation of different structures using fluorophores helps during various steps of operations. In our report, we used two fluorophores—indocyanine green (ICG), and methylene blue (MB)—during different...

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Autores principales: Polom, Wojciech, Migaczewski, Marcin, Skokowski, Jaroslaw, Swierblewski, Maciej, Cwalinski, Tomasz, Kalinowski, Leszek, Pedziwiatr, Michal, Matuszewski, Marcin, Polom, Karol
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8778329/
https://www.ncbi.nlm.nih.gov/pubmed/35054062
http://dx.doi.org/10.3390/jcm11020368
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author Polom, Wojciech
Migaczewski, Marcin
Skokowski, Jaroslaw
Swierblewski, Maciej
Cwalinski, Tomasz
Kalinowski, Leszek
Pedziwiatr, Michal
Matuszewski, Marcin
Polom, Karol
author_facet Polom, Wojciech
Migaczewski, Marcin
Skokowski, Jaroslaw
Swierblewski, Maciej
Cwalinski, Tomasz
Kalinowski, Leszek
Pedziwiatr, Michal
Matuszewski, Marcin
Polom, Karol
author_sort Polom, Wojciech
collection PubMed
description Introduction: Image-guided surgery is becoming a new tool in colorectal surgery. Intraoperative visualisation of different structures using fluorophores helps during various steps of operations. In our report, we used two fluorophores—indocyanine green (ICG), and methylene blue (MB)—during different steps of colorectal surgery, using one camera system for two separate near-infrared wavelengths. Material and methods: Twelve patients who underwent complex open or laparoscopic colorectal surgeries were enrolled. Intravenous injections of MB and ICG at different time points were administered. Visualisation of intraoperative ureter position and fluorescent angiography for optimal anastomosis was performed. A retrospective analysis of patients treated in our departments during 2020 was performed, and data about ureter injury and anastomotic site complications were collected. Results: Intraoperative localisation of ureters with MB under fluorescent light was possible in 11 patients. The mean signal-to-background ratio was 1.58 ± 0.71. Fluorescent angiography before performing anastomosis using ICG was successful in all 12 patients, and none required a change in position of the planned colon resection for anastomosis. The median signal-to-background ratios was 1.25 (IQR: 1.22–1.89). Across both centres, iatrogenic injury of the ureter was found in 0.4% of cases, and complications associated with anastomosis was found in 5.5% of cases. Conclusions: Our study showed a substantial opportunity for using two different fluorophores in colorectal surgery, whereby the visualisation of one will not change the possible quantification analysis of the other. Using two separate dyes during one procedure may help in optimisation of the fluorescent properties of both dyes when using them for different applications. Visualisation of different structures by different fluorophores seems to be the future of image-guided surgery, and shows progress in optical technologies used in image-guided surgery.
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spelling pubmed-87783292022-01-22 Multispectral Imaging Using Fluorescent Properties of Indocyanine Green and Methylene Blue in Colorectal Surgery—Initial Experience Polom, Wojciech Migaczewski, Marcin Skokowski, Jaroslaw Swierblewski, Maciej Cwalinski, Tomasz Kalinowski, Leszek Pedziwiatr, Michal Matuszewski, Marcin Polom, Karol J Clin Med Article Introduction: Image-guided surgery is becoming a new tool in colorectal surgery. Intraoperative visualisation of different structures using fluorophores helps during various steps of operations. In our report, we used two fluorophores—indocyanine green (ICG), and methylene blue (MB)—during different steps of colorectal surgery, using one camera system for two separate near-infrared wavelengths. Material and methods: Twelve patients who underwent complex open or laparoscopic colorectal surgeries were enrolled. Intravenous injections of MB and ICG at different time points were administered. Visualisation of intraoperative ureter position and fluorescent angiography for optimal anastomosis was performed. A retrospective analysis of patients treated in our departments during 2020 was performed, and data about ureter injury and anastomotic site complications were collected. Results: Intraoperative localisation of ureters with MB under fluorescent light was possible in 11 patients. The mean signal-to-background ratio was 1.58 ± 0.71. Fluorescent angiography before performing anastomosis using ICG was successful in all 12 patients, and none required a change in position of the planned colon resection for anastomosis. The median signal-to-background ratios was 1.25 (IQR: 1.22–1.89). Across both centres, iatrogenic injury of the ureter was found in 0.4% of cases, and complications associated with anastomosis was found in 5.5% of cases. Conclusions: Our study showed a substantial opportunity for using two different fluorophores in colorectal surgery, whereby the visualisation of one will not change the possible quantification analysis of the other. Using two separate dyes during one procedure may help in optimisation of the fluorescent properties of both dyes when using them for different applications. Visualisation of different structures by different fluorophores seems to be the future of image-guided surgery, and shows progress in optical technologies used in image-guided surgery. MDPI 2022-01-13 /pmc/articles/PMC8778329/ /pubmed/35054062 http://dx.doi.org/10.3390/jcm11020368 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Polom, Wojciech
Migaczewski, Marcin
Skokowski, Jaroslaw
Swierblewski, Maciej
Cwalinski, Tomasz
Kalinowski, Leszek
Pedziwiatr, Michal
Matuszewski, Marcin
Polom, Karol
Multispectral Imaging Using Fluorescent Properties of Indocyanine Green and Methylene Blue in Colorectal Surgery—Initial Experience
title Multispectral Imaging Using Fluorescent Properties of Indocyanine Green and Methylene Blue in Colorectal Surgery—Initial Experience
title_full Multispectral Imaging Using Fluorescent Properties of Indocyanine Green and Methylene Blue in Colorectal Surgery—Initial Experience
title_fullStr Multispectral Imaging Using Fluorescent Properties of Indocyanine Green and Methylene Blue in Colorectal Surgery—Initial Experience
title_full_unstemmed Multispectral Imaging Using Fluorescent Properties of Indocyanine Green and Methylene Blue in Colorectal Surgery—Initial Experience
title_short Multispectral Imaging Using Fluorescent Properties of Indocyanine Green and Methylene Blue in Colorectal Surgery—Initial Experience
title_sort multispectral imaging using fluorescent properties of indocyanine green and methylene blue in colorectal surgery—initial experience
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8778329/
https://www.ncbi.nlm.nih.gov/pubmed/35054062
http://dx.doi.org/10.3390/jcm11020368
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