1. Indocyanine green fluorescence perfusion testing in robot-assisted hepatic arterial infusion pump placement.
- Author
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van Dorst RWJJ, Ten Haaft BHEA, Franssen S, Borel Rinkes IHM, Groot Koerkamp B, Swijnenburg RJ, and Hagendoorn J
- Subjects
- Humans, Male, Female, Retrospective Studies, Middle Aged, Aged, Infusions, Intra-Arterial, Optical Imaging methods, Infusion Pumps, Perfusion Imaging methods, Methylene Blue administration & dosage, Adult, Indocyanine Green administration & dosage, Robotic Surgical Procedures methods, Liver Neoplasms surgery, Liver Neoplasms diagnostic imaging, Hepatic Artery diagnostic imaging, Coloring Agents administration & dosage
- Abstract
Background: Hepatic arterial infusion pump (HAIP) treatment is a technique used to treat liver localized malignancy with intra-arterial chemotherapy. Methylene blue is generally administered to verify hepatic perfusion and exclude inadvertent extrahepatic perfusion. The use of indocyanine green dye (ICG) combined with near-infrared (NIR) fluorescence imaging during robot-assisted HAIP placement may be an attractive alternative by providing high contrast without blue discoloration of the operative field., Methods: Data was collected retrospectively from 2 centers in the Netherlands. Intraoperative perfusion of the liver segments and extrahepatic perfusion were assessed using ICG/NIR as well as methylene blue on video imaging and correlated to postoperative 99 m-Tc perfusion scintigraphy., Results: 13 patients underwent robot-assisted surgery for HAIP placement; median length of stay was 4 days, complications occurred in 4 patients. Hepatic perfusion showed identical patterns when ICG was compared with methylene blue. In 1 patient, additional extrahepatic perfusion was found using ICG, leading to further vessel ligation. Intraoperative ICG perfusion was concordant with 99 m-Tc perfusion scintigraphy., Discussion: Liver and extrahepatic perfusion determined by ICG fluorescence imaging is concordant with blue dye perfusion and 99 m-Tc perfusion scintigraphy. Therefore, ICG fluorescence imaging is deemed a safe and reliable technique for perfusion testing during robot-assisted HAIP placement., (© 2024. The Author(s).)
- Published
- 2024
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