Fluorescence-guided surgery: comprehensive review
BJS Open, vol. 7
Abstract
BACKGROUND: Despite significant improvements in preoperative workup and surgical planning, surgeons often rely on their eyes and hands during surgery. Although this can be sufficient in some patients, intraoperative guidance is highly desirable. Near-infrared fluorescence has been advocated as a potential technique to guide surgeons during surgery. METHODS: A literature search was conducted to identify relevant articles for fluorescence-guided surgery. The literature search was performed using Medical Subject Headings on PubMed for articles in English until November 2022 and a narrative review undertaken. RESULTS: The use of invisible light, enabling real-time imaging, superior penetration depth, and the possibility to use targeted imaging agents, makes this optical imaging technique increasingly popular. Four main indications are described in this review: tissue perfusion, lymph node assessment, anatomy of vital structures, and tumour tissue imaging. Furthermore, this review provides an overview of future opportunities in the field of fluorescence-guided surgery. CONCLUSION: Fluorescence-guided surgery has proven to be a widely innovative technique applicable in many fields of surgery. The potential indications for its use are diverse and can be combined. The big challenge for the future will be in bringing experimental fluorophores and conjugates through trials and into clinical practice, as well as validation of computer visualization with large data sets. This will require collaborative surgical groups focusing on utility, efficacy, and outcomes for these techniques.
Authors 7
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Paul Anthony Sutton corresponding
University of Manchester · The Christie Hospital
Affiliation as printed
Division of Cancer Sciences, University of Manchester , Manchester , UK
The Colorectal and Peritoneal Oncology Centre, Christie Hospital , Manchester , UK
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Leiden University Medical Center
Affiliation as printed
Department of Surgery, Leiden University Medical Center , Leiden , The Netherlands
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University College Dublin · Mater Misericordiae University Hospital
Affiliation as printed
RAC, Department of Surgery, Mater Misericordiae University Hospital , Dublin , Ireland
RAC, UCD Centre for Precision Surgery, University College Dublin , Dublin , Ireland
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Leiden University Medical Center
Affiliation as printed
Department of Surgery, Leiden University Medical Center , Leiden , The Netherlands
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Affiliation as printed
Clinic of Oncological, Transplantation and General Surgery, Gdansk Medical University , Gdansk , Poland
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Leiden University Medical Center
Affiliation as printed
Department of Surgery, Leiden University Medical Center , Leiden , The Netherlands
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Leiden University Medical Center
Affiliation as printed
Department of Surgery, Leiden University Medical Center , Leiden , The Netherlands
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