DeLong Jonathan C, Chakedis Jeffrey M, Hosseini Ava, Kelly Kaitlyn J, Horgan Santiago, Bouvet Michael
Department of Surgery, University of California San Diego, San Diego, California.
J Surg Oncol. 2015 Nov;112(6):650-3. doi: 10.1002/jso.24057. Epub 2015 Sep 29.
Laparoscopic adrenalectomy has become the standard of care for many adrenal tumors. However, the success of the operation hinges on identifying the adrenal vein and complete tumor resection. We demonstrate the use of a commercially available near infrared fluorescent imaging system to clearly delineate the vascular anatomy of adrenal neoplasms and enhance the border between tumor and normal tissue. We hypothesize that this will increase the safety of laparoscopic adrenalectomy.
We performed laparoscopic adrenalectomy utilizing indocyanine green (ICG) and a specialized laparoscopic fluorescence imaging system on four consecutive patients undergoing laparoscopic adrenalectomy over a 4-month period.
The adrenal arteries and vein were vividly enhanced with ICG fluorescence guidance, and the border between tumor and adjacent tissue was clearly demarcated. The operations were performed safely with minimal blood loss and short operative times. There were no complications.
Adrenal neoplasms can be resected laparoscopically under ICG fluorescence guidance and can be used to clearly identify vascular structures and enhance the borders of the tumor. This technique allows for clear identification of the adrenal vein and has the potential to improve the safety of laparoscopic adrenalectomy.
腹腔镜肾上腺切除术已成为许多肾上腺肿瘤的标准治疗方法。然而，手术的成功取决于识别肾上腺静脉和完整切除肿瘤。我们展示了使用市售的近红外荧光成像系统来清晰描绘肾上腺肿瘤的血管解剖结构，并增强肿瘤与正常组织之间的边界。我们假设这将提高腹腔镜肾上腺切除术的安全性。
在4个月的时间里，我们对连续4例接受腹腔镜肾上腺切除术的患者使用吲哚菁绿（ICG）和专门的腹腔镜荧光成像系统进行了腹腔镜肾上腺切除术。
在ICG荧光引导下，肾上腺动脉和静脉明显增强，肿瘤与相邻组织之间的边界清晰可辨。手术安全进行，出血量极少，手术时间短。无并发症发生。
肾上腺肿瘤可在ICG荧光引导下进行腹腔镜切除，可用于清晰识别血管结构并增强肿瘤边界。该技术能够清晰识别肾上腺静脉，有可能提高腹腔镜肾上腺切除术的安全性。
