Robotic right colectomy with complete mesocolic excision and indocyanine green guidance

Giuseppe Spinoglio, Wanda Petz, Simona Borin, Alessandra Nella Piccioli, Emilio Bertani

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: Robotic complete mesocolic excision (CME) has recently emerged as promising technique to enhance oncologic results in hemicolectomy for cancer. The potential near-infrared (NUR) fluorescence with indocyanine-green (UCG) dye for lymphatic mapping is under investigation and few small case-series are reported. METHODS: UCG solution was endoscopically injected the day before surgery in patients undergoing robotic right colectomy with CME using the Da Vinci Xi ® system and the bottom to up technique. During surgery the UCG was excited by light in the near-infrared (NUR) spectrum of the Firefly™ system, of the Da Vinci Xi ® system for image comparison in standard white light and NUR, and real-time visualization of the lymphatic drainage. RESULTS: Twenty patients affected by right colon cancer underwent robotic right colectomy with the bottom to up technique. No cases converted to open surgery were observed. During surgery, a fluorescent mapping of draining lymph nodes, was visualized in all the 20 patients. Un seven patients (35%), lymph nodes outside the standard lymphatic basin were identified and removed. CONCLUSUONS: The association of robotic right colectomy with the bottom to up technique and UCG-guided lymphadenectomy is a feasible and safe procedure. UCG lymphatic mapping may help to perform a correct CME, although the independent impact of these procedures on oncologic outcome deserves further investigations.

Original languageEnglish
Pages (from-to)165-169
Number of pages5
JournalMinerva Chirurgica
Volume74
Issue number2
DOIs
Publication statusPublished - Apr 2019

Keywords

  • Colectomy
  • Robotics
  • Undocyanine green

ASJC Scopus subject areas

  • Surgery

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