A dual infrared ray imaging system for sentinel node mapping against early gastric cancer: Absorption and florescence methods by infrared ray laparoscopy system combined with indocyanine green

Abstract

Evolutions in minimally invasive surgical techniques and advances in sentinel node navigation surgery (SNNS) have had considerable impact on current insights into surgical treatment of gastric cancer. The current study is a clinical exploration and feasibility study of a novel detection system for sentinel biopsy using a new dual imaging system in absorption and florescence methods by infrared ray electronic endoscopy combined with indocyanine green (ICG). Sentinel node (SN) biopsy using ICG was performed in thirteen patients with early gastric cancer. At 20 min after the injection of ICG, SNs stained with ICG were observed by a newly developed infrared ray laparoscopy system (IRLS). Sentinel nodes were detected in all 13 cases. Sensitivity was 100 % (13/13). Mean number of SNs in the absorption imaging was 6.6 per patient and that in the fluorescence imaging was 15.7 per patient. There was no difference in the SN mapping between the absorption imaging and the fluorescence imaging. Detection of SNs using a new IRLS is a promising novel technique, which has both the absorption and the fluorescence imaging of ICG that can detect SN in real-time observation without disturbing the continuity of the operation and, moreover, no limitation in fatty patients.