51. Evolving applications of fluorescence guided surgery in pediatric surgical oncology: A practical guide for surgeons
- Author
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Todd E. Heaton, Roshni Dasgupta, Timothy B. Lautz, Alexander Bondoc, Abdelhafeez Abdelhafeez, Andrew M. Davidoff, and Seth D. Goldstein
- Subjects
Indocyanine Green ,medicine.medical_specialty ,Basic premise ,genetic structures ,Sentinel lymph node ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Surgical oncology ,030225 pediatrics ,medicine ,Humans ,Child ,Coloring Agents ,Fluorescent Dyes ,Surgeons ,Modality (human–computer interaction) ,business.industry ,Sentinel Lymph Node Biopsy ,General Medicine ,Evidence-based medicine ,Surgery ,Surgical Oncology ,chemistry ,030220 oncology & carcinogenesis ,Lymphatic Metastasis ,Pediatrics, Perinatology and Child Health ,Lymph Nodes ,Metastasectomy ,business ,Indocyanine green - Abstract
Fluorescence-guided surgery (FGS) is an increasingly available and popular method of visual field augmentation. The basic premise of FGS entails injection of fluorescent indocyanine green (ICG) and subsequent detection with a near-infrared (NIR) camera. For pediatric surgical oncologists, FGS remains experimental but is a promising modality for identifying tumor margins, locating metastases, performing sentinel lymph node biopsies, protecting peritumoral structures of interest, and facilitating reconstruction. Familiarity with basic ICG pharmacokinetics and NIR detection optics is critical for surgeons wishing to judiciously use FGS, as its success is firmly grounded in a thorough understanding of its capabilities and limitations. In this practical guide, we outline several well-described and innovative FGS applications by disease type, including their methods of administration, modes of detection, and typical ICG dosing paradigms. LEVEL OF EVIDENCE: V.
- Published
- 2020