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Review
. 2015 Sep;28(3):158-64.
doi: 10.1055/s-0035-1555007.

Enhanced Reality and Intraoperative Imaging in Colorectal Surgery

Frederic Ris  1 , Trevor Yeung  2 , Roel Hompes  2 , Neil J Mortensen  2
Affiliations
Review

Enhanced Reality and Intraoperative Imaging in Colorectal Surgery

Frederic Ris et al. Clin Colon Rectal Surg. 2015 Sep.

Abstract

Colorectal surgery is one of the most common procedures performed around the world with more than 600,000 operations each year in the United States, and more than a million worldwide. In the past two decades, there has been a clear trend toward minimal access and surgeons have embraced this evolution. Widespread adoption of advanced minimally invasive procedures is often limited by procedural complexity and the need for specific technical skills. Furthermore, the loss of 3D vision, limited overview of the surgical field, and diminished tactile sensation make major colorectal procedures more challenging and have an impact on the surgeons' learning curves. New technologies are emerging that can compensate for some of the sensory losses associated with laparoscopy. High-definition picture acquisition, 3D camera systems, and the use of biomarkers will allow improved identification of the target structures and help differentiate them from surrounding tissues. In this article, we describe some of the new technologies available and, in particular, focus on the possible implications of biomarkers and fluorescent laparoscopic imaging.

Keywords: biomarkers; colorectal surgery; enhanced reality; imaging; indocyanine green; laparoscopic colorectal cancer resection.

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Figures

Fig. 1
Fig. 1
Near infrared (NIR) imaging after vessel division in a low anterior resection (Left up: normal view, middle left: NIR mode, and low left: composite view mixed). (A) Before injection of indocyanine green (ICG), the clamp shows the planned level of transection. (B) After apparition of the signal with the main screen with the composite view, showing a clear cut off of the signal.
Fig. 2
Fig. 2
Near infrared (NIR) imaging after side to end anastomosis in a low anterior resection (Left up: normal view, middle left: NIR mode, and low left: composite view mixed). (A) Before injection of indocyanine green (ICG). (B) After ICG injection, main screen with the NIR black and white image, showing a good microperfusion of the anastomosis.
Fig. 3
Fig. 3
Lymph node mapping after tumoral indocyanine green injection (Left up: normal view, middle left: NIR mode, and low left: composite view mixed).
See this image and copyright information in PMC

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