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金色视野:黄色增强在腹腔镜腹部手术及外科手术教育中的潜力

Golden vision: The potential of yellow enhancement in laparoscopic abdominal surgeries and surgical education.

作者信息

Singh Harpreet, Koh Frederick Hong Xiang

机构信息

Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore.

Department of Colorectal Surgery, Sengkang General Hospital, Singapore 544886, Singapore.

出版信息

World J Gastrointest Endosc. 2025 Jul 16;17(7):107872. doi: 10.4253/wjge.v17.i7.107872.

DOI:10.4253/wjge.v17.i7.107872
PMID:40677583
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12264841/
Abstract

Laparoscopic imaging has advanced significantly, with higher resolutions like 4K, and innovative light modes such as narrow band imaging and near-infrared imaging. Recently, yellow enhancement (YE) mode has emerged as a novel tool that enhances the pale-yellow colour of fat into a fluorescent yellow-green, improving contrast without the need for injected dyes. It can be toggled on and off easily during surgery. YE is still under evaluation, but early experience suggests it helps surgeons differentiate anatomical planes and key intra-abdominal structures from surrounding adipose tissue. This is particularly useful in: (1) Dissecting structures surrounded or covered by fat; and (2) operating on patients with obesity, where excess intra-abdominal fat limits visualisation and retraction. By enhancing the visibility of vascular pedicles, ureters, and nerves, YE enables more precise dissections and may reduce the risk of accidental injury. It can also assist less experienced surgeons in identifying important structures, potentially improving efficiency and surgical outcomes. As a training tool, YE may shorten the learning curve, though further study is needed. Overall, YE offers potential benefits in fat-dense surgical fields by improving visualisation, reducing complications, and enhancing patient safety.

摘要

腹腔镜成像技术有了显著进步,具备如4K这样的高分辨率,以及窄带成像和近红外成像等创新的光照模式。最近,黄色增强(YE)模式已成为一种新型工具,它能将脂肪的淡黄色增强为荧光黄绿色,无需注射染料就能提高对比度。在手术过程中可以轻松地开启和关闭该模式。YE仍在评估中,但早期经验表明,它有助于外科医生区分解剖层面以及腹内关键结构与周围脂肪组织。这在以下情况中特别有用:(1)解剖被脂肪包围或覆盖的结构;(2)为肥胖患者进行手术,因为腹内过多脂肪会限制视野和牵拉操作。通过增强血管蒂、输尿管和神经的可视性,YE能实现更精确的解剖,并可能降低意外损伤的风险。它还可以帮助经验不足的外科医生识别重要结构,有可能提高手术效率和改善手术效果。作为一种培训工具,YE可能会缩短学习曲线,不过还需要进一步研究。总体而言,YE通过改善视野、减少并发症和提高患者安全性,在脂肪密集的手术领域具有潜在益处。

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本文引用的文献

1
Yellow enhancement imaging facilitates identification of surgical planes and key structures during challenging high anterior resection in a patient with obesity.黄色增强成像有助于在肥胖患者进行具有挑战性的高位前切除术时识别手术平面和关键结构。
Ann Coloproctol. 2025 Apr;41(2):169-172. doi: 10.3393/ac.2024.00465.0066. Epub 2025 Apr 14.
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Preoperative visceral fat area predicts intraoperative adverse events during lymphadenectomy in laparoscopic gastrectomy for gastric cancer: a post hoc analysis.术前内脏脂肪面积可预测胃癌腹腔镜胃切除术中淋巴结清扫时的术中不良事件:一项事后分析。
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Efficacy and safety of indocyanine green-fluorescence imaging guided liver resection: a single-arm prospective cohort study.
吲哚菁绿荧光成像引导下肝切除术的疗效与安全性:一项单臂前瞻性队列研究。
Langenbecks Arch Surg. 2025 Jan 11;410(1):34. doi: 10.1007/s00423-024-03602-7.
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Laparoscopic right hemicolectomy with complete mesocolon excision and cranial approach.腹腔镜右半结肠切除术,伴完整结肠系膜切除及头侧入路。
Surg Endosc. 2025 Jan;39(1):657-660. doi: 10.1007/s00464-024-11461-y. Epub 2024 Dec 9.
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The role of yellow enhancement in laparoscopy.黄色增强在腹腔镜检查中的作用。
Br J Surg. 2024 Oct 30;111(11). doi: 10.1093/bjs/znae288.
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Essential knowledge and technical tips for total mesorectal excision and related procedures for rectal cancer.直肠癌全直肠系膜切除及相关手术的基本知识和技术要点
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Aberrant Vascular Anatomy During Laparoscopic Cholecystectomy: A Case Report of Double Cystic Artery.腹腔镜胆囊切除术中异常血管解剖:双重胆囊动脉 1 例报告。
CRSLS. 2023 Nov 6;10(4). doi: 10.4293/CRSLS.2023.00038. eCollection 2023 Oct-Dec.
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European Association for Endoscopic Surgery (EAES) consensus on Indocyanine Green (ICG) fluorescence-guided surgery.欧洲内镜外科学会(EAES)关于吲哚菁绿(ICG)荧光引导手术的共识。
Surg Endosc. 2023 Mar;37(3):1629-1648. doi: 10.1007/s00464-023-09928-5. Epub 2023 Feb 13.
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Three-dimensional visualization of the total mesorectal excision plane for dissection in rectal cancer surgery and its ability to predict surgical difficulty.直肠癌手术中全直肠系膜切除术平面的三维可视化及其预测手术难度的能力。
Sci Rep. 2023 Feb 6;13(1):2130. doi: 10.1038/s41598-023-29426-x.
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Vascular and hormonal interactions in the adrenal gland.肾上腺中的血管和激素相互作用。
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