Published in:

Open Access 17-07-2024 | Cytostatic Therapy

Indocyanine green fluorescence perfusion testing in robot-assisted hepatic arterial infusion pump placement

Authors: Roderick W. J. J. van Dorst, Britte H. E. A. Ten Haaft, Stijn Franssen, Inne H. M. Borel Rinkes, Bas Groot Koerkamp, Rutger-Jan Swijnenburg, Jeroen Hagendoorn

Published in: Surgical Endoscopy | Issue 9/2024

Abstract

Background

Hepatic arterial infusion pump (HAIP) treatment is a technique used to treat liver localized malignancy with intra-arterial chemotherapy. Methylene blue is generally administered to verify hepatic perfusion and exclude inadvertent extrahepatic perfusion. The use of indocyanine green dye (ICG) combined with near-infrared (NIR) fluorescence imaging during robot-assisted HAIP placement may be an attractive alternative by providing high contrast without blue discoloration of the operative field.

Methods

Data was collected retrospectively from 2 centers in the Netherlands. Intraoperative perfusion of the liver segments and extrahepatic perfusion were assessed using ICG/NIR as well as methylene blue on video imaging and correlated to postoperative 99 m-Tc perfusion scintigraphy.

Results

13 patients underwent robot-assisted surgery for HAIP placement; median length of stay was 4 days, complications occurred in 4 patients. Hepatic perfusion showed identical patterns when ICG was compared with methylene blue. In 1 patient, additional extrahepatic perfusion was found using ICG, leading to further vessel ligation. Intraoperative ICG perfusion was concordant with 99 m-Tc perfusion scintigraphy.

Discussion

Liver and extrahepatic perfusion determined by ICG fluorescence imaging is concordant with blue dye perfusion and 99 m-Tc perfusion scintigraphy. Therefore, ICG fluorescence imaging is deemed a safe and reliable technique for perfusion testing during robot-assisted HAIP placement.

Graphical abstract

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Title: Indocyanine green fluorescence perfusion testing in robot-assisted hepatic arterial infusion pump placement
Authors: Roderick W. J. J. van Dorst
Britte H. E. A. Ten Haaft
Stijn Franssen
Inne H. M. Borel Rinkes
Bas Groot Koerkamp
Rutger-Jan Swijnenburg
Jeroen Hagendoorn
Publication date: 17-07-2024
Publisher: Springer US
Keywords: Cytostatic Therapy
Scintigraphy
Published in: Surgical Endoscopy / Issue 9/2024
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-024-11010-7

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Indocyanine green fluorescence perfusion testing in robot-assisted hepatic arterial infusion pump placement

Abstract

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Results

Discussion

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