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Advanced intraoperative imaging methods for laparoscopic anatomy navigation: an overview

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Abstract

Background

Safety and efficiency are important topics in minimally invasive surgery. Apart from its advantages, laparoscopic surgery has the following drawbacks: two-dimensional imaging, challenging eye–hand coordination, and absence of tactile feedback. Enhanced imaging with earlier and clearer identification of essential tissue types can partly overcome these disadvantages. Research groups worldwide are investigating new technologies for image-guided surgery purposes. This review article gives an overview of current developments in surgical optical imaging for improved anatomic identification and physiologic tissue characterization during laparoscopic gastrointestinal surgery.

Methods

A systematic literature search in the PubMed database was conducted. Eligible studies reported on any kind of novel optical imaging technique applied for anatomic identification or physiologic tissue characterization in laparoscopic gastrointestinal surgery. Gynecologic and urologic procedures also were included whenever vascular, nerve, ureter, or lymph node imaging was concerned.

Results

Various surgical imaging techniques for enhanced intraoperative visualization of essential tissue types (i.e., blood vessel, bile duct, ureter, nerve, lymph node) and for tissue characterization purposes such as assessment of blood perfusion were identified. An overview of preclinical and clinical experiences is given as well as the potential added value for intraoperative anatomic localization and characterization during laparoscopy.

Conclusion

Implementation of new optical imaging methods during laparoscopic gastrointestinal surgery can improve intraoperative anatomy navigation. This may lead to increased patient safety (preventing iatrogenic functional tissue injury) and procedural efficiency (shorter operating time). Near-infrared fluorescence imaging seems to possess the greatest potential for implementation in clinical practice in the near future.

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Abbreviations

MIS:

Minimally invasive surgery

NOTES:

Natural orifice transluminal endoscopic surgery

SILS:

Single-incision laparoscopic surgery

IR:

Infrared

IOC:

Intraoperative cholangiography

NIRFC:

Near-infrared fluorescence cholangiography

ICG:

Indocyanin green

NIR:

Near-infrared

MB:

Methylene blue

SLN:

Sentinel lymph node

HSI:

Hyperspectral imaging

OCT:

Optical coherence tomography

OI:

Optoacoustic imaging

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Acknowledgments

We thank Dr. M. Poeze (trauma surgeon, Maastricht University Medical Center) for assistance with the setup for the systematic literature search.

Disclosures

Rutger M. Schols, Nicole D. Bouvy, Ronald M. van Dam, and Laurents P. S. Stassen have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Department of Surgery, Maastricht University Medical Center, P.O. Box 5800, 6202, AZ Maastricht, The Netherlands

    Rutger M. Schols, Nicole D. Bouvy, Ronald M. van Dam & Laurents P. S. Stassen

  2. NUTRIM School for Nutrition, Toxicology, and Metabolism, Maastricht University, Maastricht, The Netherlands

    Rutger M. Schols, Nicole D. Bouvy, Ronald M. van Dam & Laurents P. S. Stassen

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  1. Rutger M. Schols
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  2. Nicole D. Bouvy
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  4. Laurents P. S. Stassen
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Correspondence to Rutger M. Schols.

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Schols, R.M., Bouvy, N.D., van Dam, R.M. et al. Advanced intraoperative imaging methods for laparoscopic anatomy navigation: an overview. Surg Endosc 27, 1851–1859 (2013). https://doi.org/10.1007/s00464-012-2701-x

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