Tracer Injection to Guide Stomach Cancer Lymph Node Dissection
Radical lymphadenectomy can improve tumor staging accuracy and long-term survival of patients with gastric cancer. The procedure is typically performed by eye and depends on a surgeon’s experience. Indocyanine green (ICG) near-infrared (NIR) fluorescent imaging has improved sentinel lymph node localization in other cancers and has been incorporated into laparoscopic device technology. This procedure video illustrates injection of ICG tracer before a planned laparoscopic gastrectomy for gastric cancer. A day before the procedure, the ICG powder is dissolved in sterile water and the prepared solution is injected along the submucosa of the stomach at 4 points around the primary tumor. The following day, the gastrectomy is performed using a surgical system with a fluorescence mode to obtain NIR images of surrounding lymph nodes. Lymph node–bearing soft tissue is retrieved, and the lymph node itself is dissected in vitro under NIR imaging.
Click https://ja.ma/2w2tXJu for a video of the general lymph node dissection procedure
Click https://ja.ma/2PoSO18 for a video of a dissection procedure for residual lymph node–bearing soft tissue
Click https://ja.ma/2I0Glw9 for a video of in vitro lymph node retrieval under direct NIR imaging
Click https://ja.ma/2vfIAsU for a complete discussion of the procedure and the findings from a trial comparing it with non–ICG tracer-guided lymph node dissection.
-
Category
No comments found