Intra‐operative fluorescent cholangiography using indocyanin green during robotic single site cholecystectomy

Abstract

RSSC using ICG for biliary tree fluorescence imaging can be performed safely. Fluorescent cholangiography enabled real-time identification of the extra-hepatic biliary anatomy using a near infrared camera integrated to the robot. Its routine clinical use merits further investigations.

SAGES TAVAC safety and effectiveness analysis: da Vinci® Surgical System (Intuitive Surgical, Sunnyvale, CA)

“…In addition to the use of a novel robotic platform, this technology also has the capability of fluorescent imaging using an integrated near-infrared camera following indocyanine green (ICG) administration for real-time visualization of biliary anatomy. This has been advocated by some groups to help facilitate bile duct visualization during the procedure in efforts to reduce biliary injury [146]. The real-time visualization of a patient's biliary anatomy requires a simple push of a button to swap between the white-light and the near-infrared camera filter feature built into the most recent robotic system.…”

Operating room of the future

“…Nearinfrared imaging has been used in delineating surgical anatomy, including sentinel-node mapping, ureteric and biliary imaging. [54][55][56] Although indocyanine green and methylene blue are non-specific contrast agents, industry stake holders are actively developing cancer-specific NIR optical probes, with phase 1 trials completed for a probe in breast cancer.…”

Comparing Near-Infrared Imaging with Indocyanine Green to Conventional Imaging During Laparoscopic Cholecystectomy: A Prospective Crossover Study

“…[27][28][29][30][31][32] The various moments at which ICG injection has been reported include 30-60 minutes before arrival in the operating room or the start of surgery, to just before induction of general anesthesia, and even following endotracheal intubation. [31][32][33][34][35][36] The dose used in the present study was 0.05 mg/kg. The first and third patients received ICG 1-2 hours prior to the start of surgery, based on the reported peak in concentration of ICG in bile 120 minutes after intravenous injection.…”