Advanced intraoperative imaging methods for laparoscopic anatomy navigation 21 Results Based on the literature search six general optical imaging modalities, with potential clinical value for future implementation in laparoscopic gastrointestinal surgery, were distinguished. We give an overview of the current capabilities of these modalities with respect to intraoperative differentiation and localization of specific anatomical structures, and regarding potential for real‐time physiological tissue assessment. A brief summary is presented in Table 2.1. Infrared ray imaging Infrared (IR) imaging also referred to as thermography, measures and displays temperature differences and changes of tissues. After cold saline injection differentiation of vital anatomical structures can be provided using a laparoscopic infrared imaging system, with an assumed maximum tissue penetration of at least 5 mm4. In laparoscopic animal studies it was shown5 that IR‐imaging can facilitate the identification of the ureter and the assessment of organ perfusion. Subsequently, the clinical utility was assessed4,6. Using IR‐laparoscopy vessel identification, assessment of organ perfusion, and transperitoneal localization of the ureter can be obtained. The use of an infrared ureteral stent7 is a more invasive way of infrared identification of the ureter in laparoscopic procedures. Based on the evaluation of intraoperative infrared cholangiography performed in open8 and laparoscopic9 surgical experiments with porcine models, IR‐imaging was suggested as a feasible alternative to the traditional intraoperative cholangiography (IOC). Infrared ray laparoscopy for sentinel lymph node (SLN) mapping has been studied during laparoscopy‐assisted colectomy in patients with colorectal cancer10. In these patients saline was injected near the tumor before indocyanine green was injected. Regional lymph nodes and lymph vessels could be clearly visualized, which was not possible by conventional laparoscopy. Furthermore, the feasibility of using an infrared ray electronic endoscopic system with ICG injection has shown great potential for sentinel node navigation surgery in gastric cancer11,12.
To see the actual publication please follow the link above