Skip to main content
SpringerLink
Log in

A novel endoscopic fluorescent clip for the localization of gastrointestinal tumors

  • New Technology
  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

Accurate tumor localization is essential for gastrointestinal surgery, especially in cases of early cancer. This study was designed to develop a novel fluorescent clip for rapid and exact visualization of tumor sites.

Methods

A transparent polymer matrix containing highly bright fluorochromes was coated on the front end of endoscopic clips. The fluorescent clips were placed on the mucosal surface of a porcine colon and stomach, and the operator then attempted to identify the fluorescent clips from the outer serosal side of the colon and stomach. A 532-nm diode laser and filter glass were used for visualizing the fluorescence signals through the colonic tissue. A 650-nm diode laser and a digital charge-coupled device (CCD) camera equipped with a bandpass emission filter were used for the imaging of the fluorescent clips through the thick stomach tissue.

Results

When a green light from a 532-nm diode laser (power density = 0.35 mW/cm2) was applied on the serosal surface of the porcine colon, we could identify all clips that had been placed endoscopically on the mucosal surface of the inner colonic wall. By using the light from a 650-nm diode laser (power density = 0.7 mW/cm2), we identified all fluorescent clips through the stomach wall in real time. Similar results were also obtained with the filtered xenon lamp.

Conclusion

An endoscopic fluorescent clip can be useful for the rapid and exact localization of tumors, and this technique can also be useful during laparoscopic surgery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Montorsi M, Opocher E, Santambrogio R, Bianchi P, Faranda C, Arcidiacono P, Passoni GR, Cosentino F (1999) Original technique for small colorectal tumor localization during laparoscopic surgery. Dis Colon Rectum 42:819–822

    Article  PubMed  CAS  Google Scholar 

  2. Park JW, Sohn DK, Hong CW, Han KS, Choi DH, Chang HJ, Lim SB, Choi HS, Jeong SY (2008) The usefulness of preoperative colonoscopic tattooing using a saline test injection method with prepackaged sterile India ink for localization in laparoscopic colorectal surgery. Surg Endosc 22:501–505

    Article  PubMed  CAS  Google Scholar 

  3. Cho YB, Lee WY, Yun HR, Lee WS, Yun SH, Chun HK (2007) Tumor localization for laparoscopic colorectal surgery. World J Surg 31:1491–1495

    Article  PubMed  Google Scholar 

  4. Beretvas RI, Ponsky J (2001) Endoscopic marking: an adjunct to laparoscopic gastrointestinal surgery. Surg Endosc 15:1202–1203

    Article  PubMed  CAS  Google Scholar 

  5. Park DJ, Lee HJ, Kim SG, Jung HC, Song IS, Lee KU, Choe KJ, Yang HK (2005) Intraoperative gastroscopy for gastric surgery. Surg Endosc 19:1358–1361

    Article  PubMed  CAS  Google Scholar 

  6. Price N, Gottfried MR, Clary E, Lawson DC, Baillie J, Mergener K, Westcott C, Eubanks S, Pappas TN (2000) Safety and efficacy of India ink and indocyanine green as colonic tattooing agents. Gastrointest Endosc 51:438–442

    Article  PubMed  CAS  Google Scholar 

  7. Weissleder R, Ntziachristos V (2003) Shedding light onto live molecular targets. Nat Med 9:123–128

    Article  PubMed  CAS  Google Scholar 

  8. Muller MG, Georgakoudi I, Zhang Q, Wu J, Feld MS (2001) Intrinsic fluorescence spectroscopy in turbid media: disentangling effects of scattering and absorption. Appl Opt 40:4633–4646

    Article  PubMed  CAS  Google Scholar 

  9. Ntziachristos V, Ripoll J, Wang LV, Weissleder R (2005) Looking and listening to light: the evolution of whole-body photonic imaging. Nat Biotechnol 23:313–320

    Article  PubMed  CAS  Google Scholar 

  10. Hyung WJ, Lim JS, Cheong JH, Kim J, Choi SH, Song SY, Noh SH (2005) Intraoperative tumor localization using laparoscopic ultrasonography in laparoscopic-assisted gastrectomy. Surg Endosc 19:1353–1357

    Article  PubMed  CAS  Google Scholar 

  11. Fu KI, Fujii T, Kato S, Sano Y, Koba I, Mera K, Saito H, Yoshino T, Sugito M, Yoshida S (2001) A new endoscopic tattooing technique for identifying the location of colonic lesions during laparoscopic surgery: a comparison with the conventional technique. Endoscopy 33:687–691

    Article  PubMed  CAS  Google Scholar 

  12. Sawaki A, Nakamura T, Suzuki T, Hara K, Kato T, Kato T, Hirai T, Kanemitsu Y, Okubo K, Tanaka K, Moriyama I, Kawai H, Katsurahara M, Matsumoto K, Yamao K (2003) A two-step method for marking polypectomy sites in the colon and rectum. Gastrointest Endosc 57:735–737

    Article  PubMed  Google Scholar 

  13. Askin MP, Waye JD, Fiedler L, Harpaz N (2002) Tattoo of colonic neoplasms in 113 patients with a new sterile carbon compound. Gastrointest Endosc 56:339–342

    Article  PubMed  Google Scholar 

  14. Zako T, Hyodo H, Tsuji K, Tokuzen K, Kishimoto H, Ito M, Kaneko K, Maeda M, Soga K (2010) Development of near infrared-fluorescent nanophosphors and applications for cancer diagnosis and therapy. J Nanomater. doi:10.1155/2010/491471

    Google Scholar 

  15. Magde D, Rojas GE, Seybold PG (1999) Solvent dependence of the fluorescence lifetimes of xanthene dyes. Photochem Photobiol 70:737–744

    Article  CAS  Google Scholar 

  16. Vallittu PK, Ekstrand K (1999) In vitro cytotoxicity of fibre-polymethyl methacrylate composite used in dentures. J Oral Rehabil 26:666–671

    Article  PubMed  CAS  Google Scholar 

  17. Vallittu PK (1995) A review of methods used to reinforce polymethyl methacrylate resin. J Prosthodont 4:183–187

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

This study was supported by a grant from the National Cancer Center of Korea (NCC-1010060).

Disclosures

Drs. Y. D. Choi, K. G. Kim, J. K. Kim, K. W. Nam, H. H. Kim, and D. K. Sohn have no conflicts of interest or financial ties to disclose.

Author information

Authors and Affiliations

  1. Molecular Imaging and Therapy Branch, Research Institute and Hospital, National Cancer Center, Goyang, Korea

    Yongdoo Choi & Joa Kyum Kim

  2. Biomedical Engineering Branch, Research Institute and Hospital, National Cancer Center, Goyang, Korea

    Kwang Gi Kim, Kyoung Won Nam & Hyun Ho Kim

  3. Colorectal Cancer Branch, Research Institute and Hospital, National Cancer Center, 111 Jungbalsan-ro, Ilsandong-gu, Gyeonggi-do, Goyang, 410-769, Republic of Korea

    Dae Kyung Sohn

Authors
  1. Yongdoo Choi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kwang Gi Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Joa Kyum Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kyoung Won Nam
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hyun Ho Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Dae Kyung Sohn
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Dae Kyung Sohn.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (AVI 9065 kb)

Rights and permissions

Reprints and permissions

About this article

Cite this article

Choi, Y., Kim, K.G., Kim, J.K. et al. A novel endoscopic fluorescent clip for the localization of gastrointestinal tumors. Surg Endosc 25, 2372–2377 (2011). https://doi.org/10.1007/s00464-010-1557-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-010-1557-1

Keywords

Search

Navigation