Usefulness of Preoperative Endoscopic Fluorescent Clip Marking in Laparoscopic Gastrointestinal Surgery

Abstract

Background/Aim: Precise tumor localization during gastrointestinal surgery improves curability and function preservation. We investigated the efficacy of preoperative endoscopic fluorescent clip marking using a Zeoclip FS with built-in near-infrared fluorescent resins in delineating gastrointestinal cancer for surgery. Patients and Methods: We evaluated the intraoperative visibility of the Zeoclip FS using a VISERA ELITE 2 and the short-term outcomes of 37 cancer patients (colorectal, n=23; gastric, n=14) who underwent preoperative fluorescent clip marking. Results: The study included 23 male and 14 female subjects with a mean age of 73 years (range=39-87 years). Thirty-three patients (89.1%) exhibited clear fluorescent clip marking and easily determined transection lines. Fluorescence was not observed in 1 sigmoid colon cancer patient (2.7%), who required a colonic stent for preoperative obstruction. Three patients (8.1%) required additional procedures for fluorescence visualization. Conclusion: Endoscopic fluorescent clip marking can delineate tumors well for determining the extent of resection.

Efficacy and Safety of Gastrointestinal Tumour Site Marking with da Vinci‐Compatible Near‐Infrared Fluorescent Clips: A Case Series

“…Based on the reported eight articles [3,4,[14][15][16][17][18][19], tumour site marking was performed with conventional NIRFC without any adverse effects, which is in line with the present study.…”

“…In addition, care should be taken with the angle between the camera and intestine. If the intestinal wall thickness is 5 mm, the angle at which near-infrared light can be observed within a biological transmission distance of 10 mm must be at least 30° [ 14 ]. For these conditions, Namikawa et al [ 1 ] sent 100 ml air into the stomach through a nasogastric tube during observation, making the stomach wall extended and thin.…”

Indocyanine Green Fluorescence Guided Surgery in Colorectal Surgery

“…They reported the use of a novel fluorescent clip (ZEOCLIP FS, Zeon Medical Co, Tokyo, Japan), which was placed a few days prior to the surgery and was easily detected from the serosal side intraoperatively. Similar clips were more recently reported by Lee et al [ 57 ] and Ryu et al [ 58 ].…”

Near-infrared fluorescence clip guided robot-assisted wedge resection of a gastric submucosal tumour: A case report

“…We have been involved in the development of near-infrared fluorescent clip (NIRFC): ZEOCLIP FS® (Zeon Medical, Tokyo, Japan) for intraoperative recognition of the location of gastrointestinal tumors. The NIRFC is effective in laparoscopic surgery [1] , [2] . However, this clip is difficult to observe with the da Vinci® Firefly ( Fig.…”