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Visualization of the Stomach's Arterial Networks During Esophageal Surgery Using the HyperEye Medical System

Hiroyuki Kitagawa1, Tsutomu Namikawa2, Masaya Munekage1

  • 1Department of Surgery, Kochi Medical School, Nankoku, Kochi, Japan.

Anticancer Research
|October 28, 2015
PubMed

Insights

The HyperEye Medical System (HEMS) line-marking method (LMM) safely visualizes stomach arterial networks (ANS) before gastric tube creation, potentially reducing leakage in esophageal surgery.

Area of Science:

  • Surgical Innovation
  • Medical Imaging Technology
  • Gastrointestinal Surgery

Background:

  • Gastric tube (GT) creation during esophageal surgery requires clear visualization of stomach arterial networks (ANS) for safe reconstruction.
  • Current methods may not adequately delineate the ANS blood supply, posing risks of anastomotic leakage.
  • Indocyanine green fluorescence with the HyperEye Medical System (HEMS) offers potential for improved intraoperative visualization.

Purpose of the Study:

  • To investigate the visualization of stomach arterial networks (ANS) during gastric tube (GT) creation using indocyanine green fluorescence and HEMS.
  • To evaluate the feasibility of the HEMS-line-marking method (LMM) for delineating the ANS blood supply before GT creation.
  • To assess the impact of the HEMS-LMM on anastomotic leakage rates in esophageal surgery.

Main Methods:

  • A retrospective review of 51 patients undergoing esophageal surgery with GT reconstruction.
  • Control group (n=28): HEMS used after GT creation to confirm blood supply.
  • HEMS-LMM group (n=23): HEMS used before GT creation to visualize and mark the ANS border.

Main Results:

  • The HEMS-LMM successfully visualized the ANS border prior to GT creation.
  • The anastomotic leakage rate decreased from 17.9% in the control group to 4.4% in the HEMS-LMM group (p=0.204).
  • The HEMS-LMM demonstrated safety and feasibility in delineating the blood supply of the right gastroepiploic artery.

Conclusions:

  • The HEMS-LMM is a safe and feasible technique for visualizing the blood supply border of the right gastroepiploic artery and ANS.
  • Applying HEMS-LMM before GT creation in esophageal surgery may lead to a reduction in anastomotic leakage.
  • This method enhances intraoperative assessment of vascularity crucial for successful gastric tube reconstruction.
Abstract

Keywords:
HyperEye medical systemIndocyanine green fluorescencegastric tubeline-marking method

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