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Surgical Endoscopy

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01-02-2017

A feasibility study of the use of computed virtual chromoendoscopy for laparoscopic evaluation of peritoneal metastases

Authors: Haythem Najah, Réa Lo Dico, Anthony Dohan, Lucy Marry, Clarisse Eveno, Marc Pocard

Published in: Surgical Endoscopy | Issue 2/2017

Abstract

Background

Detection of an incipient peritoneal carcinomatosis (PC) is still challenging, and there is a crucial need for technological improvements in order to diagnose and to treat early this condition. Fujinon Intelligent Chromo Endoscopy (FICE) is a spectral image processing technology that enhances the contrast of the target tissue. The aim of this study is to investigate the usefulness of FICE system during peritoneal endoscopy and to establish the optimal FICE preset(s) for peritoneal exploration and PC detection.

Methods

A total of 561 images corresponding to 51 different areas of PC nodules and normal peritoneum were recorded during peritoneal endoscopies (For each area, one white light endoscopy (WLE) image and 10 FICE images). Three groups of 5 evaluators each: senior surgeons, surgical residents and medical students assessed these images. In a first questionnaire, the evaluators gave a score ranging from 1 to 10 to each image, and the three best FICE channels were determined. In a second questionnaire, five criteria were studied specifically: contrast, brightness, vascular architecture, differentiation between organs and detection of PC. The evaluators ranked the WLE and the three best FICE channel images according to these criteria.

Results

The three best FICE channels were channels 6, 2 and 9 with mean scores of 6.21 ± 1.59, 6.17 ± 1.48 and 6.06 ± 1.52, respectively. FICE Channel 2 was superior to WLE and other FICE channels, in terms of contrast (p < 10⁻⁴), visualization of vascular architecture (p < 10⁻⁴), differentiation between organs (p < 10⁻⁴) and detection of PC (p < 10⁻⁴); and ranked first in 38.8, 41.5, 31 and 46.9 % of the cases, respectively.

Conclusion

FICE system provides adequate illumination of the abdominal cavity and a unique contrast that enhances the vascular architecture. FICE Channel 2 is the optimal channel for peritoneal exploration and could be a useful tool for the diagnosis of PC during peritoneal explorations.

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Title: A feasibility study of the use of computed virtual chromoendoscopy for laparoscopic evaluation of peritoneal metastases
Authors: Haythem Najah
Réa Lo Dico
Anthony Dohan
Lucy Marry
Clarisse Eveno
Marc Pocard
Publication date: 01-02-2017
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 2/2017
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-016-5028-1

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

A feasibility study of the use of computed virtual chromoendoscopy for laparoscopic evaluation of peritoneal metastases

Abstract

Background

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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