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Related Concept Videos

Anatomy of the Adrenal Glands01:17

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The adrenal or supra-renal glands, situated above the kidneys and aligned with the twelfth rib, are paired pyramid-shaped structures crucial for the body's stress response. During stress, these glands secrete hormones vital for adaptive physiological reactions.
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Adrenal gland disorders manifest when the production of adrenal hormones deviates from the norm, resulting in either excessive or insufficient concentrations.
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Hormones of the Adrenal Glands01:31

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Adrenal hormones play a pivotal role in maintaining the body's electrolyte balance and orchestrating responses to stress, showcasing the intricate functions of the adrenal cortex and medulla.
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The sympathetic pathways of the collateral ganglia and adrenal medulla serve unique but interconnected roles in the sympathetic response.
Collateral Ganglia
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Photoluminescence is a process where a molecule absorbs light energy and re-emits it in the form of light. This phenomenon occurs when a substance absorbs photons, promoting its electrons to higher energy level excited states, followed by a relaxation process in which the electrons return to their original ground state energy levels and emit light. Photoluminescence is widely observed in various materials, including semiconductors, and organic and inorganic compounds.
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Atomic fluorescence spectroscopy (AFS) is an analytical technique that involves the electronic transitions of atoms in a flame, furnace, or plasma being excited by electromagnetic (EM) radiation. When these atoms absorb energy, they become excited and subsequently release energy as they return to their original state. This emitted light, or "fluorescence," is observed at a right angle to the incident beam. Both absorption and emission processes transpire at distinct wavelengths, which...
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A Novel Method: Super-selective Adrenal Venous Sampling
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Fluorescence techniques in adrenal surgery.

Edwina C Moore1, Eren Berber1

  • 1Department of Endocrine Surgery, Cleveland Clinic, Cleveland, OH, USA.

Gland Surgery
|August 13, 2019
PubMed
Summary
This summary is machine-generated.

Indocyanine green (ICG) fluorescence enhances minimally invasive adrenal surgery by improving visualization of critical structures and resection margins. This technique supports precise subtotal adrenalectomies, reducing the risk of adrenal insufficiency in high-risk patients.

Keywords:
Adrenal surgeryfluorescence angiographyindocyanine green (ICG)laparoscopynear infrared imaging (NIR imaging)

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Area of Science:

  • Surgical Oncology
  • Minimally Invasive Surgery
  • Medical Imaging

Background:

  • Minimally invasive adrenal surgery (laparoscopic and robotic) is increasingly common.
  • Accurate identification of vascular structures and tissue planes is crucial for safe and effective adrenalectomy.
  • Challenges remain in precisely delineating resection margins, especially in complex cases.

Purpose of the Study:

  • To describe the application of indocyanine green (ICG) fluorescence in minimally invasive adrenal surgery.
  • To highlight ICG's utility in real-time visualization of anatomical structures and resection margins.
  • To evaluate the potential of ICG fluorescence in facilitating subtotal adrenal resection and preventing complications.

Main Methods:

  • Utilized indocyanine green (ICG) as a fluorescent dye during laparoscopic and robotic adrenal surgery.
  • Employed real-time fluorescence imaging to visualize vascularity and tissue planes.
  • Focused on delineating resection margins for precise surgical dissection.

Main Results:

  • ICG fluorescence effectively aided in identifying vascular structures and parenchymal tissue planes.
  • The dye facilitated clear delineation of resection margins, enabling more precise surgical operations.
  • Subtotal adrenal resection (cortical-sparing adrenalectomy) was more accurately guided by ICG fluorescence.

Conclusions:

  • Indocyanine green fluorescence is a valuable tool in minimally invasive adrenal surgery.
  • ICG enhances surgical precision, particularly for subtotal adrenalectomies in patients with bilateral disease or high recurrence risk.
  • This technique may reduce the incidence of iatrogenic adrenal insufficiency and its long-term complications.