Michiya Kobayashi, MD PhD, Takayuki Sato, MD PhD, Takeki Sugimoto, MD PhD, Ken Okamoto, MD PhD, Ken Dabanaka, MD, Tsutomu Namikawa, MD PhD, Takehiro Okabayashi, MD PhD, Kazuhiro Hanazaki, MD PhD. Department of Human Health and Medical Sciences, Hospital Administration Section, Department of Cardiovascular Control, and Department of Surgery, Kochi Medical School
We developed a new imaging system (HyperEye Medical System, HEMS) for simultaneously capturing near-infrared (NIR) fluorescence of indocyanine green (ICG) and visible light through a unique, high-sensitive, charge-coupled device (CCD) area sensor coated with arrays of red-, green-, blue-, and NIR-specific filters. Unlike multiple-sensor systems, HEMS enables real-time color-NIR imaging in ICG fluorescence-guided endoscopic surgery without the need for special video data laparoscope processing to superimpose the NIR signal on color images. We have developed a prototype that captures NIR fluorescence of ICG (HEMS-E) and carried out preliminary evaluation of the system in laparoscopic colon surgery.
METHODS AND PROCEDURE
To label a site of interest, we injected 0.2 ml of ICG solution (1 mg/ml) and 0.2 ml of Indian ink into the submucosal layer adjacent to the tumor to be resected.
While ICG was excited with a custom-made xeon fiber illumination system, NIR fluorescence and color images were visualized with HEMS through the NIR-compatible endoscope.
The resolution of our new endoscopic imaging is still insufficient for surgical procedures. However, our new HEMS-E imaging system could detect the fluorescence of ICG even in cases where the Indian ink was not visible by conventional laparoscopy (HD Endoeye LTF-VHTM, Olympus, Japan).
The resolution of HEMS-E should be improved to satisfy the needs of lararoscopic surgery using this system. However, the detection limits for tumor sites during laparoscopic surgery by HEMS-E is superior to that provided by a standard laparoscope using Indian ink. Further development of HEMS-E is going to meet the needs of the surgeon.
Session Number: Poster – Poster Presentations
Program Number: P406