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Immediate Lymphatic Reconstruction Using a Handheld Fluorescence Imaging Device.

Pedram Goel1, Jagmeet S Arora2, Brock Lanier1

  • 1From the Department of Plastic Surgery, University of California, Irvine, Orange, Calif.

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|December 19, 2023
PubMed
Summary
This summary is machine-generated.

A handheld fluorescence imaging device offers a safe and effective alternative for identifying lymphatic channels during immediate lymphatic reconstruction (ILR). This method enables lymphaticovenous bypass (LVB) creation, expanding access to ILR when specialized microscopes are unavailable.

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Area of Science:

  • Surgical Innovation
  • Medical Imaging
  • Lymphatic Surgery

Background:

  • Immediate lymphatic reconstruction (ILR) traditionally relies on fluorescent microscopes for lymphatic channel identification.
  • A novel approach utilizes a handheld fluorescence imaging device as an alternative.

Purpose of the Study:

  • To evaluate the safety and efficacy of a handheld fluorescence imaging device for identifying lymphatic channels during ILR.
  • To assess the feasibility of lymphaticovenous bypass (LVB) creation using this device.

Main Methods:

  • A single-center study involving 15 consecutive patients undergoing ILR.
  • Intraoperative intradermal indocyanine green injection followed by identification of lymphatic channels with a handheld device (SPY-PHI, Stryker).
  • Construction of LVB using a non-fluorescent microscope or loupes.

Main Results:

  • The handheld device successfully identified lymphatic channels in all 15 cases.
  • LVB creation was completed in all patients.
  • ILR was performed for various cancers including breast, ovarian, and melanoma, as well as other conditions.

Conclusions:

  • Immediate lymphatic reconstruction using indocyanine green and a handheld fluorescence imaging device is safe and effective.
  • This method facilitates ILR when fluorescent microscopes are not available, increasing patient access.
  • Successful LVB creation was achieved in all cases.