Intracorporeal lymph node mapping in colon cancer surgery.

Area of Science:

• Oncology
• Surgical Innovation
• Medical Imaging

Background:

• The optimal lymphadenectomy strategy for colon cancer remains debated, with a focus on standardized versus tailored techniques.
• Current approaches often use "one size fits all" lymph node harvest methods.
• Tailoring lymph node removal to individual lymphatic patterns offers a potential alternative.

Purpose of the Study:

• To introduce and evaluate a novel technique for individualized lymph node mapping in colon cancer surgery.
• To guide surgeons intraoperatively by visualizing patient-specific lymphatic drainage patterns.

Main Methods:

• Intracorporeal injection of 10 mg indocyanine green at four points around the colonic tumor.
• Intraoperative assessment of fluorescence using a near-infrared camera after specimen mobilization.
• Lymphadenectomy guided by visualized lymphatic drainage before specimen extraction.

Main Results:

• A video demonstration of the described technique is presented.
• Preliminary results from six patients indicate feasibility and safety.
• The method allows for lymphadenectomy based on individual lymphatic pathways.

Conclusions:

• Intracorporeal lymph node mapping is a feasible and safe technique in oncologic colon surgery.
• Further research is necessary to establish the role of this individualized approach in modern surgical practice.
• This technique may offer a more precise method for lymphadenectomy in colon cancer.