Related Experiment Video
Updated: Mar 5, 2026
Multispectral Real-time Fluorescence Imaging for Intraoperative Detection of the Sentinel Lymph Node in Gynecologic Oncology
Published on: October 20, 2010
Fluorescein Isothiocyanate: A Novel Application for Lymphatic Surgery
Lisa Spiguel1, Christiana Shaw, Adam Katz
1From the *Department of Surgery; †Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Florida School of Medicine, Gainesville, FL; ‡Department of Plastic and Reconstructive Surgery, Lahey Clinic, Burlington, MA; §Department of Plastic and Reconstructive Surgery, China Medical University Hospital, China Medical University, Taichung, Taiwan; and ∥Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
Fluorescein isothiocyanate offers a safe and effective method for intraoperative lymphatic mapping during the Lymphatic Microsurgical Preventing Healing Approach (LYMPHA) procedure. This novel application aids in identifying lymphatic channels for lymphovenous bypass, reducing lymphedema risk in breast cancer patients.
Area of Science:
- Surgical Oncology
- Microsurgery
- Lymphedema Research
Background:
- The Lymphatic Microsurgical Preventing Healing Approach (LYMPHA) procedure uses lymphovenous bypass (LVB) during axillary lymph node dissection to mitigate lymphedema.
- Traditional methods for identifying lymphatic vessels during LVB often rely on blue dye or indocyanine green.
Purpose of the Study:
- To evaluate the safety and efficacy of fluorescein isothiocyanate as a novel agent for intraoperative lymphatic mapping in the LYMPHA procedure.
- To demonstrate the utility of fluorescein isothiocyanate in visualizing lymphatic channels for lymphovenous bypass.
Main Methods:
- A prospective database review of breast cancer patients who underwent the LYMPHA procedure between March and September 2015.
- Intraoperative lymphatic mapping using fluorescein isothiocyanate to identify lymphatic channels for LVB after axillary lymph node dissection.
- Analysis of preoperative and intraoperative variables, including the number of identified and bypassed lymphatic channels.
Main Results:
- Thirteen patients underwent LYMPHA with fluorescein isothiocyanate lymphatic mapping.
- An average of 3.4 lymphatic channels were identified, with an average of 1.7 bypassed per patient.
- No intraoperative adverse events were recorded, indicating a favorable safety profile.
Conclusions:
- Fluorescein isothiocyanate is a safe and effective tool for intraoperative lymphatic mapping in microsurgical procedures.
- Its ability to allow simultaneous dissection and lymphatic visualization makes it ideal for open surgical fields like the LYMPHA procedure.
- This method aids in precise lymphatic identification and bypass, potentially improving outcomes for lymphedema prevention.
