title: Near-Infrared Sentinel Lymph Node Mapping With Indocyanine Green Using the VITOM II ICG Exoscope for Open Surgery for Gynecologic Malignancies.
abstract: Sentinel lymph node (SLN) mapping is emerging as an effective method for surgical staging of different gynecologic malignancies. Near-infrared (NIR) technology using a fluorescent dye such as indocyanine green (ICG) represents an interesting and feasible method for SLN mapping even in traditional open surgeries by applying video telescope operating microscope (VITOM) system technology. We report our preliminary experience in 12 women who underwent surgical nodal staging for early-stage vulvar and uterine or cervical cancer. Surgical and pathological outcomes are described, and the VITOM II ICG system's intraoperative image quality, handling and docking, and teaching value are assessed. The general impression of the surgical staff was that the VITOM II system is easy to use, and that the image quality of the anatomic structures is impressive. Traditional open SLN mapping with ICG appears to be easy to perform and reproducible, providing a new tool in the management of patients with gynecologic malignancies. Moreover, we believe that this technology has great potential as an operative teaching and learning modality for trainers for open surgical cases. Additional studies involving the VITOM system with a large sample size of patients are needed to confirm these promising results.
authors.affiliation: Gynecologic Oncology Unit, Dept. Obstet and Gynecol, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy. Electronic address: alebuda1972@gmail.com.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Buda
authors.affiliation: Gynecologic Oncology Unit, Dept. Obstet and Gynecol, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy.
authors.forename: Tiziana
authors.initials: T
authors.lastname: Dell'Anna
authors.affiliation: Gynecologic Oncology Unit, Dept. Obstet and Gynecol, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Vecchione
authors.affiliation: Gynecologic Oncology Unit, Dept. Obstet and Gynecol, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy.
authors.forename: Debora
authors.initials: D
authors.lastname: Verri
authors.affiliation: Gynecologic Oncology Unit, Dept. Obstet and Gynecol, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy.
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Di Martino
authors.affiliation: Gynecologic Oncology Unit, Dept. Obstet and Gynecol, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy.
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Milani
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D005456:Fluorescent Dyes; D006801:Humans; D061705:Image-Guided Biopsy / Q000295:instrumentation / Q000379:methods; D007208:Indocyanine Green; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009367:Neoplasm Staging; D000071036:Sentinel Lymph Node / Q000473:pathology*; D021701:Sentinel Lymph Node Biopsy / Q000295:instrumentation / Q000379:methods; D019265:Spectroscopy, Near-Infrared / Q000379:methods; D025321:Surgery, Computer-Assisted / Q000295:instrumentation / Q000379:methods; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery; D014594:Uterine Neoplasms / Q000473:pathology / Q000601:surgery*; D020535:Video-Assisted Surgery / Q000295:instrumentation / Q000379:methods; D014846:Vulvar Neoplasms / Q000473:pathology / Q000601:surgery*
chemical_list: D005456:Fluorescent Dyes; D007208:Indocyanine Green
keywords: Gynecologic malignancies; Real-time fluorescence; Sentinel lymph node; Video telescope