The usefulness of preoperative colonoscopic tattooing using a saline test injection method with prepackaged sterile India ink for localization in laparoscopic colorectal surgery.
BACKGROUND
Laparoscopic surgery for colorectal neoplasm requires precise tumor localization. The authors have assessed the safety and efficacy of colonoscopic tattooing using a saline test injection method with prepackaged sterile India ink for tumor localization in laparoscopic colorectal surgery.


METHODS
Between July 2004 and January 2007, 63 patients underwent colonoscopic tattooing using prepackaged sterile India ink before laparoscopic surgery of colorectal tumors. Patient medical records and operation videos were retrospectively assessed.


RESULTS
Tattoos were visualized intraoperatively in 62 (98.4%) of the 63 patients, and colorectal tumors were accurately localized in 61 patients (96.8%). In one patient, the tattoo could not be detected, whereas in another patient, it was visualized but the serosal surface of the rectosigmoid colon was stained diffusely. Both of these patients underwent intraoperative colonoscopy. Localized leakages of ink were identified in six patients (9.5%) during surgery. However, five of these patients had no symptoms, and the sixth patient, who underwent polypectomy and tattooing simultaneously, felt mild chilling without fever or abdominal pain.


CONCLUSIONS
Preoperative colonoscopic tattooing using a saline test injection method with prepackaged sterile India ink is a safe and effective method for tumor localization in laparoscopic colorectal surgery.
Park
J W
JW
Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, 809 Madu-dong, Ilsan-gu, Goyang, Gyeonggi, 411-769, Korea.
Sohn
D K
DK
Hong
C W
CW
Han
K S
KS
Choi
D H
DH
Chang
H J
HJ
Lim
S-B
SB
Choi
H S
HS
Jeong
S-Y
SY
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002244:Carbon / Q000008:administration & dosage*; D003113:Colonoscopy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D007267:Injections; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods*; D012965:Sodium Chloride / Q000008:administration & dosage; D013653:Tattooing
C028433:chinese ink; D012965:Sodium Chloride; D002244:Carbon
World J Surg. 2006 Apr;30(4):605-11
16555023
N Engl J Med. 2004 May 13;350(20):2050-9
15141043
Surg Endosc. 2002 May;16(5):808-11
11997827
Endoscopy. 1983 Jul;15(4):266-9
6884285
Cancer. 1958 May-Jun;11(3):607-10
13523569
Gastrointest Endosc. 1975 Aug;22(1):42-3
1205106
Dis Colon Rectum. 1999 Oct;42(10):1353-5
10528779
Gastrointest Radiol. 1987;12 (4):343-6
3623005
Surg Endosc. 1997 Oct;11(10):1013-6
9381339
Dis Colon Rectum. 1994 Aug;37(8):775-6
7519975
Endoscopy. 2001 Aug;33(8):687-91
11490385
Gastrointest Endosc. 1991 Jan-Feb;37(1):65-8
1706285
Am J Gastroenterol. 1996 Sep;91(9):1804-8
8792702
Gastrointest Endosc. 2000 Apr;51(4 Pt 1):438-42
10744816
Am Surg. 1993 Mar;59(3):205-10
8476162
Gastrointest Endosc. 1991 Jan-Feb;37(1):99-100
1706288
Lancet. 2002 Jun 29;359(9325):2224-9
12103285
J Gastrointest Surg. 2004 Jul-Aug;8(5):543-6
15239988
Am J Gastroenterol. 1992 Jan;87(1):79-81
1370188
Dis Colon Rectum. 1999 Jun;42(6):819-22
10378609
Gastrointest Endosc. 1991 Jan-Feb;37(1):68-71
1706286
Gastrointest Endosc. 2002 Sep;56(3):339-42
12196769
Gastrointest Endosc. 1997 Feb;45(2):153-6
9041001
Am Surg. 1989 Jul;55(7):457-61
2472762
Surg Endosc. 1999 Apr;13(4):397-400
10094755