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Extra-luminal detection of assumed colonic tumor site by near-infrared laparoscopy

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Abstract

Background

Localization of colorectal tumors during laparoscopic surgery is generally performed by tattooing into the submucosal layer of the colon. However, faint and diffuse tattoos may lead to difficulties in recognizing cancer sites, resulting in inappropriate resection of the colon. We previously demonstrated that yttrium oxide nanoparticles doped with the rare earth ions (ytterbium and erbium) (YNP) showed strong near-infrared (NIR) emission under NIR excitation (1550 nm emission with 980 nm excitation). NIR light can penetrate deep tissues. In this study, we developed an NIR laparoscopy imaging system and demonstrated its use for accurate resection of the colon in swine.

Methods

The NIR laparoscopy system consisted of an NIR laparoscope, NIR excitation laser diode, and an NIR camera. Endo-clips coated with YNP (NIR clip), silicon rubber including YNP (NIR silicon mass), and YNP solution (NIR ink) were prepared as test NIR markers. We used a swine model to detect an assumed colon cancer site using NIR laparoscopy, followed by laparoscopic resection. The NIR markers were fixed at an assumed cancer site within the colon by endoscopy. An NIR laparoscope was then introduced into the abdominal cavity through a laparoscopy port.

Results

NIR emission from the markers in the swine colon was successfully recognized using the NIR laparoscopy imaging system. The position of the markers in the colon could be identified. Accurate resection of the colon was performed successfully by laparoscopic surgery under NIR fluorescence guidance. The presence of the NIR markers within the extirpated colon was confirmed, indicating resection of the appropriate site.

Conclusions

NIR laparoscopic surgery is useful for colorectal cancer site recognition and accurate resection using laparoscopic surgery.

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Acknowledgments

We are grateful to Machida Endoscope Co. and Mr. Go Mita (Mitagiken Co. Ltd) for custom-made laparoscopy and NIR-VIS image splitter system, respectively. We thank Dr. Kenichi Koushi, MD (Department of Colorectal Surgery, National Cancer Center Hospital East) for tattooing images in laparoscopic surgery, and Prof. Toshiyuki Watanabe and Ms. Shiori Abe (Nagoya Zokei University) for the (Fig. 1) illustrations. We also thank doctors from National Cancer Center Hospital East and students from Tokyo University of Science (Soga laboratory and Kishimoto laboratory) for the help in laparoscopic surgery using model swine.

Funding

New Energy and Industrial Technology Development Organization (NEDO) of Japan (Industrial Technology Research Grant Program in 2009), RIKEN (Molecular Systems research), National Cancer Center Research & Development Fund (25-A-8 & 26-A-17) and Accelerating Regulatory Science Initiative (H-24), Program for Development of Strategic Research Center in Private Universities supported by Ministry of Education, Culture, Sport, Science, and Technology, Japan (MEXT), and Tokyo University of Science, 2009–2013 (S0901020).

Author information

Author notes

  1. Hiroshi Hyodo

    Present address: Institute of Multidisciplinary Research for Advanced Materials, Tohoku University, Sendai, Miyagi, Japan

  2. Tamotsu Zako

    Present address: Department of Chemistry and Biology, Graduate School of Science and Engineering, Ehime University, 2-5 Bunkyo, Matsuyama, 790-8577, Ehime, Japan

Authors and Affiliations

  1. Bioengineering Laboratory, RIKEN Institute, 2-1 Hirosawa, Wako, Saitama, 351-0198, Japan

    Tamotsu Zako, Miya Yoshimoto & Mizuo Maeda

  2. Department of Material Science and Technology, Tokyo University of Science, 6-3-1 Niijuku, Katsushika, Tokyo, 125-8585, Japan

    Hiroshi Hyodo, Miya Yoshimoto, Kohei Soga & Mizuo Maeda

  3. Department of Mechanical Engineering, Tokyo University of Science, Noda, Chiba, Japan

    Masayuki Watanabe & Hiroshi Takemura

  4. Research Institute for Biomedical Sciences, Tokyo University of Science, Noda, Chiba, Japan

    Hidehiro Kishimoto

  5. Department of Colorectal Surgery, Surgical Technology Division, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan

    Masaaki Ito

  6. Department of Gastroenterology, Endoscopy Division, National Cancer Center Hospital East, Kashiwa, Chiba, Japan

    Kazuhiro Kaneko

  7. Graduate School of Medicine, University of the Ryukyus, Nakagami, Okinawa, Japan

    Hidehiro Kishimoto

Authors
  1. Tamotsu Zako
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  2. Masaaki Ito
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  3. Hiroshi Hyodo
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  4. Miya Yoshimoto
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  8. Kazuhiro Kaneko
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  9. Kohei Soga
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  10. Mizuo Maeda
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Corresponding authors

Correspondence to Tamotsu Zako, Masaaki Ito or Kohei Soga.

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Disclosures

Tamotsu Zako, Masaaki Ito, Hiroshi Hyodo, Miya Yoshimoto, Masayuki Watanabe, Hiroshi Takemura, Hidehiro Kishimoto, Kazuhiro Kaneko, Kohei Soga and Mizuo Maeda have no conflict of interest or financial ties to disclose.

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Zako, T., Ito, M., Hyodo, H. et al. Extra-luminal detection of assumed colonic tumor site by near-infrared laparoscopy. Surg Endosc 30, 4153–4159 (2016). https://doi.org/10.1007/s00464-015-4669-9

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  • DOI: https://doi.org/10.1007/s00464-015-4669-9

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