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Review
. 2021 Sep;34(5):338-344.
doi: 10.1055/s-0041-1729866. Epub 2021 Sep 3.

Immunofluorescence in Robotic Colon and Rectal Surgery

Matthew C Bobel  1 , Ariella Altman  1 , Wolfgang B Gaertner  1
Affiliations
Review

Immunofluorescence in Robotic Colon and Rectal Surgery

Matthew C Bobel et al. Clin Colon Rectal Surg. 2021 Sep.

Abstract

The indocyanine green fluorescence imaging system is a surgical tool with increasing applications in colon and rectal surgery that has received growing acceptance in various surgical disciplines as a potentially valid method to enhance surgical field visualization, improve lymph node retrieval, and decrease anastomotic leak. Small noncomparative prospective trials have shown that intraoperative fluorescence imaging is a safe and feasible method to assess anastomotic perfusion and that its use may impact anastomotic leak rates. However, larger prospective and randomized studies are required to validate its role and impact in colorectal surgery. The purpose of this article is to review the current status of the use of immunofluorescence in colon and rectal surgery, as well as new applications in robotic colon and rectal resections.

Keywords: Firefly; immunofluorescence; indocyanine green; robotic colorectal surgery.

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Conflict of interest statement

Conflict of Interest • Intuitive surgical: proctor, speaker. • Coloplast: MD advisory board, consultant. • Applied Medical: consultant.

Figures

Fig. 1
Fig. 1
Robotic Firefly system.
Fig. 2
Fig. 2
( a and b ) Visualization of the left ureter after intraureteral injection of indocyanine green, using the Firefly system.
Fig. 3
Fig. 3
Visualization of a mid-rectal lesion after intralesional injection of indocyanine green, using the Firefly system.
Fig. 4
Fig. 4
Fluorescence angiography of an ileo-colic ( a ) and colo-colonic ( b ) anastomosis using the Firefly system.
Fig. 5
Fig. 5
Identification of sentinel inferior mesenteric artery (IMA) lymph nodes after intra-lesional injection of indocyanine green, using the Firefl system.
See this image and copyright information in PMC

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