Surgical Endoscopy

, Volume 33, Issue 4, pp 1080–1086 | Cite as

Autologous blood, a novel agent for preoperative colonic localization: a safety and efficacy comparison study

  • Eui Joo Kim
  • Jun-Won ChungEmail author
  • Su Young Kim
  • Jung Ho Kim
  • Yoon Jae Kim
  • Kyoung Oh Kim
  • Kwang An Kwon
  • Dong Kyun Park
  • Duck Joo Choi
  • Sung Won Park
  • Jeong-Heum Baek
  • Won-Suk Lee



Preoperative localization is essential for minimally invasive colorectal surgery. However, conventional endoscopic tattooing agents such as India ink have safety issues. The availability of new endoscopic markers such as non-India-ink-based agent is limited. We assessed the efficacy and safety of preoperative endoscopic tattooing using autologous blood in colorectal surgery.


From February 2016, all patients who required localization of a target lesion before colorectal surgery underwent endoscopic tattooing using autologous blood, and the outcomes were collected prospectively. As a comparison, we retrospectively reviewed the medical records of a further 51 consecutive patients who underwent endoscopic tattooing using India ink before February 2016. A total of 102 patients who underwent endoscopic tattooing using either India ink or autologous blood were included in this study. The primary outcomes were the visibility of the tattooing in the peritoneal cavity and related adverse events.


Endoscopic tattoos produced using India ink were visible in 49 (96.1%) patients, and tattoos created using autologous blood were visible in 47 (92.2%) patients. In the autologous blood group, the tattoo could not be identified in four patients due to excessive peritoneal fat, bleeding tendency, congenital anomaly, and suboptimal tattooing. Seven (13.7%) patients in the India ink group and three (5.9%) patients in the autologous blood group experienced endoscopic tattooing-related adverse events.


Autologous blood is a feasible and safe tattooing agent for preoperative endoscopic localization of colorectal lesions within maximal interval of 5 days.


Colorectal neoplasia Endoscopy Tattooing Minimally invasive surgical procedures Laparoscopy 



This research was supported by a Grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (Grant Number: HI16C2319).

Compliance with ethical standards


Eui Joo Kim, Jun-Won Chung, Su Young Kim, Jung Ho Kim, Yoon Jae Kim, Kyoung Oh Kim, Kwang An Kwon, Dong Kyun Park, Duck Joo Choi, Sung Won Park, Jeong-Heum Baek, and Won-Suk Lee have no conflicts of interest or financial ties to disclose.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Eui Joo Kim
    • 1
  • Jun-Won Chung
    • 1
    Email author
  • Su Young Kim
    • 1
  • Jung Ho Kim
    • 1
  • Yoon Jae Kim
    • 1
  • Kyoung Oh Kim
    • 1
  • Kwang An Kwon
    • 1
  • Dong Kyun Park
    • 1
  • Duck Joo Choi
    • 1
  • Sung Won Park
    • 2
  • Jeong-Heum Baek
    • 2
  • Won-Suk Lee
    • 2
  1. 1.Department of Internal Medicine, Gachon University Gil Medical CenterGachon University College of MedicineIncheonRepublic of Korea
  2. 2.Department of Surgery, Gachon University Gil Medical CenterGachon University College of MedicineIncheonRepublic of Korea

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