改良的低位直肠手术中的尿道荧光显影：一种新染料和新方法。
Improved urethral fluorescence during low rectal surgery: a new dye and a new method.
机构信息
Nuffield Department of Surgical Sciences, John Radcliffe Hospital, University of Oxford, Level 6, Headley Way, Headington, Oxford, OX3 9DS, UK.
Department of Colorectal Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
出版信息
Tech Coloproctol. 2018 Feb;22(2):115-119. doi: 10.1007/s10151-018-1757-6. Epub 2018 Feb 19.
BACKGROUND
The aim of this study was to demonstrate highlighting of the urethra during surgery through the use of two different methods: a new near-infrared fluorophore IRDye800BK, and indocyanine green (ICG) mixed with silicone.
METHODS
Male cadavers from the department of anatomy at the University of Oxford were used to visualise the urethra during near-infrared fluorescence excitation. To assess IRDye800BK, a perineal incision was utilised after infiltrating the urethra directly with an IRDye800BK solution mixed with Instillagel. ICG-silicone was assessed when the urethra was purposely exposed as part of a simulated transanal total mesorectal dissection. ICG was previously mixed with ethanol and silicone and left to set in a Foley catheter. Fluorescence was visualised using an in-house manufactured fluorescence-enabled laparoscopic system.
RESULTS
IRDye800BK demonstrated excellent penetration and visualisation of the urethra under fluorescence at an estimated tissue depth of 2 cm. An ICG-silicone catheter demonstrated excellent fluorescence without leaving any residual solution behind in the urethra after its removal.
CONCLUSIONS
The newly described ICG-silicone method opens up the possibility of new technologies in this area of fluorescence guided surgery. IRDye800BK is a promising alternative to ICG in visualising the urethra using fluorescence imaging. Its greater depth of penetration may allow earlier detection of the urethra during surgery and prevent wrong plane surgery sooner.
背景
本研究旨在通过两种不同方法展示手术过程中尿道的显影：一种新的近红外荧光染料 IRDye800BK，以及与硅胶混合的吲哚菁绿（ICG）。
方法
牛津大学解剖学系的男性尸体被用于在近红外荧光激发下可视化尿道。为评估 IRDye800BK，我们在会阴切口后直接向尿道内注射 IRDye800BK 溶液与 Instillagel 的混合物以浸润尿道。当尿道作为模拟经肛门全直肠系膜切除术的一部分被故意暴露时，评估 ICG-硅胶。ICG 之前与乙醇和硅胶混合，并留在 Foley 导管中使其凝固。荧光使用内部制造的荧光腹腔镜系统进行可视化。
结果
IRDye800BK 在估计的组织深度为 2cm 时表现出出色的尿道穿透性和荧光可视化效果。ICG-硅胶导管在移除后，尿道内没有留下任何残留溶液，表现出出色的荧光。
结论
新描述的 ICG-硅胶方法为荧光引导手术领域的新技术开辟了可能性。IRDye800BK 是一种在荧光成像中可视化尿道的有前途的 ICG 替代物。其更深的穿透深度可能允许在手术期间更早地检测到尿道，并更早地防止错误的手术平面。
Zotero 插件