Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jul 1;10(1):164.
doi: 10.1186/s40792-024-01964-0.

Visualization of cecal tumor by near-infrared laparoscopy and intraoperative colonoscopy

Kaori Watanabe  1 , Hiroki Takahashi  2 , Shuhei Uehara  1 , Akira Kato  1 , Yoshiaki Fujii  1 , Takeshi Yanagita  1 , Takuya Suzuki  1 , Hajime Ushigome  1 , Yuzo Maeda  1 , Ryo Ogawa  1 , Yoichi Matsuo  1 , Akira Mitsui  1 , Shuji Takiguchi  1
Affiliations

Visualization of cecal tumor by near-infrared laparoscopy and intraoperative colonoscopy

Kaori Watanabe et al. Surg Case Rep. .

Abstract

Background: In laparoscopic colorectal surgery, accurate localization of a tumor is essential for ensuring an adequate ablative margin. Therefore, a new method, near-infrared laparoscopy combined with intraoperative colonoscopy, was developed for visualizing the contour of a cecal tumor from outside of the bowel. The method was used after it was verified on a model that employed a silicone tube.

Case presentation: The patient was a 77-year-old man with a cecal tumor near the appendiceal orifice. Laparoscopy was used to clamp of the terminal ileum, and a colonoscope was then inserted through the anus to the cecum. The laparoscope in the normal light mode could not be used to identify the cecal tumor. However, a laparoscope in the near-infrared ray mode could clearly visualize the contour of the cecal tumor from outside of the bowel, and the tumor could be safely resected by a stapler. The histopathological diagnosis of the resected specimen was adenocarcinoma with an invasion depth of M and a clear negative margin.

Conclusions: This is the first report of the laparoscopic detection of the contour of a cecal tumor from outside the bowel. This technique is useful and safe for contouring tumors in laparoscopic colorectal surgery and can be used in various surgeries that combine endoscopy and laparoscopy.

Keywords: Cecal tumor; Colonoscopy; Laparoscopic surgery; Near-infrared ray.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Preoperative examinations. a Colonoscopy findings. A 15-mm sessile serrated polyp was identified near the junction of the cecum and appendix; b computed tomography (CT) showed no metastases to other organs or lymph nodes
Fig. 2
Fig. 2
Verification on a silicon model. a Observation within the lumen by a colonoscope; b normal light observation from outside the bowel by a laparoscope; c near-infrared ray observation from outside the bowel by a laparoscope (Da Vinci Firefly mode)
Fig. 3
Fig. 3
Intraoperative findings. a Schematic of port placement; b observation within the lumen by a colonoscope; c normal light observation from outside the bowel by a laparoscope; d near-infrared ray observation from outside the bowel by a laparoscope (Stryker 4K SPY mode); e colonoscopy after resection
Fig. 4
Fig. 4
Results. a Resected specimen. Histopathological examination showed negative margins; b colonoscopy at 1 postoperative year was negative for recurrence
See this image and copyright information in PMC

References

    1. Oka S, Tanaka S, Kajiwara Y, Saito S, Fukunaga Y, Takamatsu M, et al. Treatment decision for locally resected T1 colorectal carcinoma-verification of the Japanese Guideline Criteria for additional surgery based on long-term clinical outcomes. Am J Gastroenterol. 2024 doi: 10.14309/ajg.0000000000002715. - DOI - PMC - PubMed
    1. Detering R, Rutgers MLW, Bemelman WA, Hompes R, Tanis PJ. Prognostic importance of circumferential resection margin in the era of evolving surgical and multidisciplinary treatment of rectal cancer: a systematic review and meta-analysis. Surgery. 2021;170:412–431. doi: 10.1016/j.surg.2021.02.029. - DOI - PubMed
    1. Takahashi H, Yanagita TE, Suzuki T, Maeda A, Nakai N, Maeda Y, et al. Accurate localization of rectal cancer using near infrared ray-guided surgery with intra-operative colonoscopy and da Vinci Firefly technology. Surg Today. 2020;50:205–208. doi: 10.1007/s00595-019-01864-z. - DOI - PubMed
    1. van der Pas MH, Haglind E, Cuesta MA, Fürst A, Lacy AM, Hop WC, et al. Laparoscopic versus open surgery for rectal cancer (COLOR II): short-term outcomes of a randomised, phase 3 trial. Lancet Oncol. 2013;14:210–218. doi: 10.1016/S1470-2045(13)70016-0. - DOI - PubMed
    1. Feng Q, Yuan W, Li T, Tang B, Jia B, Zhou Y, et al. Robotic versus laparoscopic surgery for middle and low rectal cancer (REAL): short-term outcomes of a multicentre randomised controlled trial. Lancet Gastroenterol Hepatol. 2022;7:991–1004. doi: 10.1016/S2468-1253(22)00248-5. - DOI - PubMed

LinkOut - more resources