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Simultaneous multipurpose fluorescence imaging with IRDye® 800BK during laparoscopic surgery.

Mahdi Al-Taher1,2, Manuel Barberio3, Eric Felli3

  • 1Institute of Image-Guided Surgery, IHU Strasbourg, 1, Place de l'Hôpital, 67091, Strasbourg, France. mahdi.al-taher@ihu-strasbourg.eu.

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|August 30, 2020
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Summary

This study shows IRDye® 800BK can visualize multiple structures and assess bowel perfusion during surgery. This near-infrared fluorescence (NIRF) dye is a promising tool for image-guided surgery.

Keywords:
Bile duct imagingBowel perfusionLaparoscopic surgeryLymphographyNear-infrared fluorescenceUreteral visualization

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Area of Science:

  • Surgical Innovation
  • Medical Imaging
  • Fluorescence-guided Surgery

Background:

  • IRDye® 800BK is a fluorophore with biliary and renal clearance undergoing clinical translation.
  • No current fluorophore allows simultaneous non-invasive visualization of structures and perfusion evaluation using near-infrared fluorescence (NIRF).

Purpose of the Study:

  • To evaluate IRDye® 800BK for simultaneous assessment of bowel perfusion, lymphography, ureter, and bile duct delineation.
  • To explore its utility in image-guided surgery.

Main Methods:

  • Six pigs received intravenous IRDye® 800BK (0.15 mg/kg).
  • Fluorescence intensity (FI) and time to peak FI were measured in ischemic bowel loops, correlated with capillary lactate.
  • Ureters, bile ducts, and gastric lymphatics were assessed using NIRF imaging up to 180 minutes post-injection.

Main Results:

  • NIRF imaging provided excellent visualization of ureters and bowel perfusion.
  • Bile ducts, gastric lymph ducts, and lymph nodes were successfully visualized.
  • A significant positive correlation was found between time to peak FI in ischemic bowel and capillary lactate levels (rho 0.59, p<0.001).

Conclusions:

  • IRDye® 800BK demonstrated simultaneous multipurpose applicability during laparoscopic surgery.
  • This fluorophore shows potential as a versatile tool for image-guided surgery.