Laparoscopic Sentinel Lymph Node Mapping with Indocyanine Green Using the iSpies Platform: Initial Experience...

Area of Science:

• Gynecology
• Surgical Oncology
• Medical Imaging

Background:

• Sentinel lymph node mapping is crucial for staging early-stage cervical cancer.
• Minimally invasive techniques like laparoscopic surgery are preferred for reduced morbidity.
• Access to advanced imaging technologies, such as indocyanine green (ICG) fluorescence, can be limited in developing countries due to cost.

Purpose of the Study:

• To report the initial experience in Argentina using the iSpies indocyanine green (ICG) platform for sentinel lymph node mapping.
• To assess the safety and feasibility of this technique in patients with early-stage cervical cancer.

Main Methods:

• A step-by-step demonstration of the laparoscopic sentinel lymph node mapping technique using ICG and the iSpies near-infrared camera.
• ICG was administered via cervical injection, followed by detection of sentinel lymph nodes using near-infrared imaging.
• The procedure was performed on a 47-year-old patient with stage IB1 squamous cervical cancer.

Main Results:

• Bilateral sentinel lymph nodes were successfully identified in the left external iliac artery and right obturator space.
• The procedure was completed within 170 minutes with minimal blood loss and no intraoperative or postoperative complications.
• Final pathology confirmed a tumor confined to the cervix with negative margins and disease-free lymph nodes.

Conclusions:

• The iSpies ICG platform is safe and feasible for sentinel lymph node mapping in early-stage cervical cancer in Argentina.
• This technology presents a valuable option for resource-limited settings, potentially avoiding extensive lymphadenectomy.
• Expanding access to such minimally invasive imaging technologies can improve patient outcomes in developing countries.