Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Ann Surg Oncol. 2020 Dec;27(13):5322. doi: 10.1245/s10434-020-08523-5. Epub 2020 May 7.
Robotic surgery technology has significant advantages, but its limitations include lack of tactile feedback. Fluorescent-imaging technology, part of the da Vinci robotic surgery system, helps to overcome this lack of feedback and improve safety. This video demonstrates the utility of fluorescent-image guidance in robotic subtotal gastrectomy. First, peritumoral injection of indocyanine green helps localize the primary lesion. Second, it enables visualization of sentinel lymphatic flow to guide the extent of lymph node dissection. Third, intravenous injection of indocyanine green confirms adequate tissue perfusion of the remnant stomach. Lastly, fluorescent angiography also visualizes the jejunal arterial arcade in the mesentery. In summary, we consider that fluorescent-image guidance may provide important intraoperative information that supports techniques of robotic subtotal gastrectomy. Further studies to validate the benefits of fluorescent-image guidance are needed.
机器人手术技术具有显著优势，但也存在局限性，例如缺乏触觉反馈。达芬奇机器人手术系统的荧光成像技术有助于克服这种反馈缺失，提高手术安全性。本视频演示了荧光图像引导在机器人胃次全切除术的应用。首先，肿瘤周围注射吲哚菁绿有助于定位原发性病变。其次，可显示前哨淋巴结的淋巴流动，指导淋巴结清扫范围。第三，静脉注射吲哚菁绿确认残胃组织灌注充足。最后，荧光血管造影还可显示肠系膜中的空肠动脉弓。总之，我们认为荧光图像引导可能为机器人胃次全切除术技术提供重要的术中信息。需要进一步的研究来验证荧光图像引导的益处。
