Masumi Wada, Shinichiro Mori, Yoshiaki Kita, Kenji Baba, Kan Tanabe, Masayuki Yanagi, Takaaki Arigami, Yasuto Uchikado, Kosei Maemura, Masahiko Sakoda, Shoji Natsugoe. Department of Digestive, Breast and Thyroid Surgery, Graduate School of Medicine, Kagoshima University,
Devise: 10mm laparoscope
Objective: Assessment of blood perfusion is important to avoid postoperative anastomotic leakage. Fluorescence imaging with indocyanine green (ICG) provides a real time assessment of intestinal perfusion. However it needs laparoscope equipped with near infrared ray. The aim of this study was to evaluate the clinical utility of laparoscopic assisted vessel enhancement (LAVE) method using 10mm laparoscope in the decision of the transection line during laparoscopic colorectal surgery with anastomosis.
Methods: Prospectively collected data of 20 patients (13 men, 7 women; mean age 67 years; mean body mass index: BMI 23.5 kg/m2) with colorectal cancer who underwent anastomosis after surgery from January 2017 to December 2017 were enrolled. Surgical outcomes, complications and length of hospital stay were assessed.
Surgical procedure: After laparoscopic colectomy, LAVE method using 10mm laparoscope was performed. After marking at 10cm proximal (or distal) to tumor and letting the light weaken in the operating room, transection line of mesentery was tattooed under guidance of 10mm laparoscope. The vessels shadow was observed through the mesentery via the light of 10mm laparoscope. Then the transection of mesentery was performed until the serosa of colon appeared, preserving marginal vessels. After transection of the colon, reconstruction was performed.
Results: Mean of operative time and blood loss were 311 min and 42 g, respectively. LAVE method was not useful for 5 (25%) patients with high BMI of male. No patient had intraoperative complications. Postoperative complications occurred in one patient, who suffered pelvic infection, which resolved with conservative treatment. None of patients had anastomotic leakage and unplanned readmissions into hospital within 30 days. There was no mortality. The length of hospital stay was 14 days.
Conclusions: LAVE method would be useful for decision of transection line of colon without ICG for selected patients with colorectal cancer.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 91178
Program Number: ETP840
Presentation Session: Emerging Technology iPoster Session (Non CME)
Presentation Type: Poster
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