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[PDF: Members Only] J.Jpn. Surg. Soc.. 121(1): 19-26, 2020
Feature topic
ESTABLISHMENT OF AND NEXT STEPS IN GASTROINTESTINAL FLUORESCENCE-GUIDED SURGERY
Translucency is a characteristic of near-infrared ray fluorescence. The penetration depth is up to 1-2 cm and visualization of deep-layer structures is possible. Indocyanine green (ICG) fluorescence is widely used as a probe in near-infrared ray fluorescence, which allows assessment of the area of intestinal ischemia and blood flow in anastomoses. It is also used for sentinel lymph node mapping in gastric cancer surgery. Although a variety of administration and detection methods have been reported, acceptable results have been reliably obtained when the mean or median number of sentinel nodes per patient is 5-7. A readily available supply of fluorescent agents is expected to be developed to accelerate the spread of fluorescence-guided surgery. A near-infrared fluorescent marking clip will soon become commercially available as a good indicator of tumor location. In addition to near-infrared fluorescence, visual fluorescence is also used during surgery. In photodynamic diagnosis based on 5-aminolevulinic acid-induced protoporphyrin Ⅸ (PpⅨ), tumors are labeled with PpⅨ fluorescence with a wavelength of about 635 nm. Fluorescein fluorescence is another candidate visual fluorescent probe and can be used for the assessment of surface tissue blood flow.
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