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Novel endoscopic marking clip equipped with resin-conjugated fluorescent indocyanine green during laparoscopic surgery for gastrointestinal cancer

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Abstract

Purpose

Intraoperative identification of the cancer location is often difficult to conduct during laparoscopic surgery, especially in early-stage cancers. This study aimed to investigate the feasibility and accuracy of a novel endoscopic clip resin-conjugated fluorescent indocyanine green during laparoscopic surgery for gastrointestinal cancer.

Methods

Preoperative placement of endoscopic marking clips equipped with resin-conjugated fluorescent indocyanine green was performed to determine the resection margin in eight patients with gastrointestinal cancer. During laparoscopic surgery, a dedicated laparoscopic system with a xenon light source was used to detect fluorescence. The evaluation determined whether the fluorescent from the clips was visualized during laparoscopic surgery.

Results

Fluorescent signal emitted from ICG in the resin of the clips was detected in six patients from the outer layer of the serosal surfaces of the gastrointestinal tract, and the clips aided in accurate resection line of the organ. There were no significant differences of age, gender, and BMI between the patients in whom we could and could not detect ICG fluorescence.

Conclusions

The results demonstrated the usefulness of a novel clip-equipped fluorescent resin, which is a promising diagnostic tool to detect accurate tumor location during laparoscopic surgery.

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Authors and Affiliations

  1. Department of Surgery, Kochi Medical School, Nankoku, Kochi, Japan

    Tsutomu Namikawa, Jun Iwabu, Masaya Munekage, Sunao Uemura, Hiroyuki Kitagawa & Kazuhiro Hanazaki

  2. Center for Photodynamic Medicine, Kochi Medical School, Nankoku, Kochi, Japan

    Tsutomu Namikawa, Takayuki Sato & Kazuhiro Hanazaki

  3. Department of Gastroenterology and Hepatology, Kochi Medical School, Nankoku, Kochi, Japan

    Motoi Hashiba, Takayoshi Yamada, Hiroshi Mizuta & Kazushige Uchida

  4. Department of Human Health and Medical Sciences, Kochi Medical School, Nankoku, Kochi, Japan

    Ken Okamoto & Michiya Kobayashi

  5. Department of Cardiovascular Control, Kochi Medical School, Nankoku, Kochi, Japan

    Takayuki Sato

Authors
  1. Tsutomu Namikawa
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  2. Jun Iwabu
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  3. Motoi Hashiba
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  4. Masaya Munekage
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  5. Sunao Uemura
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  6. Takayoshi Yamada
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  7. Hiroyuki Kitagawa
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  8. Hiroshi Mizuta
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  9. Ken Okamoto
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  10. Kazushige Uchida
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  11. Takayuki Sato
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  12. Michiya Kobayashi
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  13. Kazuhiro Hanazaki
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Contributions

Study conception and design: Tsutomu Namikawa, Takayuki Sato, and Michiya Kobayashi. Acquisition of data: Tsutomu Namikawa, Jun Iwabu, Motoi Hashiba, Masaya Munekage, Sunao Uemura, Takayoshi Yamada, Hiroyuki Kitagawa, Hiroshi Mizuta, and Ken Okamoto. Analysis and interpretation of data: Tsutomu Namikawa and Kazushige Uchida. Drafting of manuscript: Tsutomu Namikawa. Critical revision of manuscript: Tsutomu Namikawa and Kazuhiro Hanazaki.

Corresponding author

Correspondence to Tsutomu Namikawa.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Cite this article

Namikawa, T., Iwabu, J., Hashiba, M. et al. Novel endoscopic marking clip equipped with resin-conjugated fluorescent indocyanine green during laparoscopic surgery for gastrointestinal cancer. Langenbecks Arch Surg 405, 503–508 (2020). https://doi.org/10.1007/s00423-020-01902-2

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  • DOI: https://doi.org/10.1007/s00423-020-01902-2

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