Confocal microlaparoscope for imaging the fallopian tube

Abstract

Recent evidence suggests that ovarian cancer can originate in the fallopian tube. Unlike many other cancers, poor access to the ovary and fallopian tubes has limited the ability to study the progression of this deadly disease and to diagnosis it during the early stage when it is most amenable to therapy. A rigid confocal microlaparoscope system designed to image the epithelial surface of the ovary in vivo was previously reported. A new confocal microlaparoscope with an articulating distal tip has been developed to enable in vivo access to human fallopian tubes. The new microlaparoscope is compatible with 5-mm trocars and includes a 2.2-mmdiameter articulating distal tip consisting of a bare fiber bundle and an automated dye delivery system for fluorescence confocal imaging. This small articulating device should enable the confocal microlaparoscope to image early stage ovarian cancer arising inside the fallopian tube. Ex vivo images of animal tissue and human fallopian tube using the new articulating device are presented along with in vivo imaging results using the rigid confocal microlaparoscope system.

Serous tubal intraepithelial carcinoma (STIC) – clinical impact and management

“…Images obtained by these probes in real time during surgery have shown a clear distinction between normal and abnormal regions within the ovarian surface epithelium [45]. Studies using a flexible microlaparoscope have demonstrated the ability to provide high-resolution images of early-stage carcinoma inside the fallopian tube in the intraoperative setting [46]. Unfortunately, image quality produced by the microlaparoscope is diminished when compared to traditional laparoscopes due to a smaller scope size, focal distance, and a reduced light output.…”

Advances in Tumor Screening, Imaging, and Avatar Technologies for High-Grade Serous Ovarian Cancer

“…Images obtained by these probes in real-time during surgery have shown a clear distinction between normal and abnormal regions within the ovarian surface epithelium ( 33 ). Furthermore, studies using a flexible microlaparoscope have demonstrated the ability to provide high-resolution images of early stage cancer inside the fallopian tube in the intra-operative setting, thereby facilitating both an earlier diagnosis and accurate disease staging ( 34 ). Since these procedures have shown merit in surgical settings, they may become a viable complementary option to traditional biopsies as future modalities of disease confirmation ( 33 ).…”