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Use of Near-Infrared Imaging and a Lighted Bougie to Improve Sleeve Gastrectomy Technique

Sarah Assali, DO1, Salim Abunnaja, MD2, Nezar Jrebi, MD2, Lawrence Tabone, MD2, Paolo Fontes, MD2, Nova Szoka, MD2. 1Allegheny General Hospital, 2West Virginia University Ruby Memorial Hospital

Introduction: This pilot study describes a novel use of near infrared imaging in laparoscopic surgery. Specifically, it examines the use of a near infrared camera and lighted bougie during laparoscopic sleeve gastrectomy to improve visualization while passing the bougie into the stomach. In this series, the near infrared camera is used without concurrent indocyanine green (ICG) dye.

Methods: From November 2016 to June 2018, ten patients underwent laparoscopic sleeve gastrectomy using near infrared imaging and lighted bougie while introducing the bougie into the stomach. The purpose of this study was to demonstrate feasibility of this novel use of near infrared technology. To show proof of concept of this technique, three types of lighted bougies were used: a lighted disposable bougie (Gastrisail), a lighted 1T Endoscope, and a lighted 2T Endoscope. Additional demographics collected included patient age, sex, preoperative BMI, operation length, and 30-day morbidity and mortality.

Results: The patient population involved in this study had an average age of 40.1 years (SD +/- 12.35) with an average pre-operative BMI of 43.55 (SD +/- 2.48). The average OR time for patients undergoing a sleeve gastrectomy utilizing this technique was 77.4 minutes (SD +/- 15.42). Three cases involved the use of the Gastrisail bougie (Figure I), four used a 1T endoscope (Figure II) , and the remaining three used a 2T endoscope. There only morbidity that was observed was one readmission for dehydration and nausea, and there were no mortalities.

Conclusion: This pilot study demonstrates a novel use of near infrared imaging and lighted bougie during laparoscopic sleeve gastrectomy; the near infrared camera is used without ICG dye. The technique is feasible and improves visualization while passing the bougie during sleeve gastrectomy. Further studies are needed to determine if this technique can lead to decreased bougie-related injuries, as well as improved team communication and surgeon satisfaction.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 98714

Program Number: ETP763

Presentation Session: Emerging Technology Poster Session (Non CME)

Presentation Type: Poster

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