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D-Light P System (Karl Storz)

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Fluorescence Imaging for Surgeons

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Abstract

Bile duct injury in patients undergoing laparoscopic cholecystectomy is a rare but serious complication. Concomitant vascular injury worsens the outcome of bile duct injury repair. Near-infrared fluorescence imaging using indocyanine green (ICG) is a promising, innovative, and noninvasive method for the intraoperative identification of biliary and vascular anatomy during cholecystectomy. The results from our clinical feasibility study illustrate that biliary and vascular fluorescence imaging in laparoscopic cholecystectomy, using the D-Light P System (Tricam SLII; Karl Storz Endoscopes) and preoperative administration of ICG, is easily applicable in clinical practice, can be helpful for earlier visualization of the biliary tree and is useful for the confirmation of the arterial anatomy.

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Abbreviations

CA:

Cystic artery

CBD:

Common bile duct

CD:

Cystic duct

CVS:

Critical view of safety

ICG:

Indocyanine green

NIRF:

Near-infrared fluorescence

TBR:

Target-to-background ratio

WL:

White light

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Author information

Authors and Affiliations

  1. Department of Surgery, Maastricht University Medical Center, P. Debyelaan 25, Maastricht, Limburg, 6229 HX, The Netherlands

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

Authors
  1. Rutger M. Schols M.D., Ph.D.
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  2. Nicole D. Bouvy M.D. Ph.D.
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  3. Ronald M. van Dam M.D.
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  4. Laurents P. S. Stassen M.D., Ph.D.
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Corresponding author

Correspondence to Rutger M. Schols M.D., Ph.D. .

Editor information

Editors and Affiliations

  1. Section of Minimally Invasive Surgery, Department of General and Vascular Surgery, The Bariatric and Metabolic Institute, Cleveland Clinic Florida, FL, USA; Oncological Surgical Division, Division of Surgical Research, Department of Surgery, Hospital de Clinicas Buenos Aires, University of Buenos Aires, Buenos Aires, Argentina

    Fernando D. Dip

  2. Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research; Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan

    Takeaki Ishizawa

  3. Hepato-Biliary-Pancreatic Surgery; Department of Surgery, Graduate School of Medicine, University of Tokyo, Bunkyo-ku, Tokyo, Japan

    Norihiro Kokudo

  4. Department of General Surgery, Section of Minimally Invasive Surgery; Department of General and Vascular Surgery, The Bariatric and Metabolic Institute, Cleveland Clinic Florida, Weston, Florida, USA

    Raul J. Rosenthal

Electronic Supplementary Material

Video 5.1

This brief video fragment presents the application of near-infrared fluorescence cholangiography during an elective laparoscopic cholecystectomy. The intraoperative snap-shots illustrated in Figs. 5.2, 5.3 and 5.4 are taken from the same surgical procedure (M4V 6,988 kb)

Video 5.2

This short video fragment illustrates concomitant fluorescence cholangiography and angiography at establishment of Critical View of Safety. Fluorescence delineation of the cystic artery is obtained after repeat ICG injection. The intraoperative snapshot as displayed in Fig. 5.5 is taken from the same surgical procedure (M4V 1,750 kb)

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© 2015 Springer International Publishing Switzerland

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Schols, R.M., Bouvy, N.D., van Dam, R.M., Stassen, L.P.S. (2015). D-Light P System (Karl Storz). In: Dip, F., Ishizawa, T., Kokudo, N., Rosenthal, R. (eds) Fluorescence Imaging for Surgeons. Springer, Cham. https://doi.org/10.1007/978-3-319-15678-1_5

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  • DOI: https://doi.org/10.1007/978-3-319-15678-1_5

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-15677-4

  • Online ISBN: 978-3-319-15678-1

  • eBook Packages: MedicineMedicine (R0)

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