title: Initial report of near-infrared fluorescence imaging as an intraoperative adjunct for lymph node harvesting during robot-assisted laparoscopic gastrectomy.
abstract: BACKGROUND
  Adequate lymphadenectomy is a fundamental aspect of oncologically sound gastrectomies. Robot-assisted laparoscopic gastrectomy is a minimally invasive alternative that allows functional imaging to be easily integrated to the surgical field and may aid in intraoperative identification of lymphovascular bundles.
  
  
  METHODS
  Indocyanine green application and near-infrared fluorescence imaging were used during robot-assisted laparoscopic gastrectomy as an adjunct for the identification of relevant lymph node basins in real time.
  
  
  RESULTS
  A total of 31 patients were included. Twenty-nine gastrectomies were performed for adenocarcinoma and two wedge resections for neuroendocrine tumors. The mean lymph node retrieval was twenty-nine (range 17-61) for adenocarcinoma and five for neuroendocrine tumors. In all cases, at least five lymph nodes were seen along the main nodal basins, which provided real time intraoperative feedback regarding lymph node identification. Average time for indocyanine green application and functional imaging was less than 10 min.
  
  
  CONCLUSIONS
  Near-infrared fluorescent imaging may provide an improved method to help visualize lymph nodes intraoperatively during robot-assisted laparoscopic gastrectomy, thus adding a potentially valuable adjunct for lymphadenectomy and overall lymph node retrieval. J. Surg. Oncol. 2016;113:768-770. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Department of Surgery, Memorial Sloan Kettering Cancer, New York, New York.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Herrera-Almario
authors.affiliation: Department of Surgery, Memorial Sloan Kettering Cancer, New York, New York.
authors.forename: Michael
authors.initials: M
authors.lastname: Patane
authors.affiliation: Thoracic Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Inderpal
authors.initials: I
authors.lastname: Sarkaria
authors.affiliation: Department of Surgery, Memorial Sloan Kettering Cancer, New York, New York.
authors.forename: Vivian E
authors.initials: VE
authors.lastname: Strong
mesh_terms: D000005:Abdomen; D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005456:Fluorescent Dyes; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D007208:Indocyanine Green; D010535:Laparoscopy; D008197:Lymph Node Excision / Q000379:methods*; D008198:Lymph Nodes / Q000000981:diagnostic imaging*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000473:pathology / Q000601:surgery; D061646:Operative Time; D061848:Optical Imaging / Q000379:methods*; D065287:Robotic Surgical Procedures; D019265:Spectroscopy, Near-Infrared; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D005456:Fluorescent Dyes; D007208:Indocyanine Green
keywords: fluorescence; indocyanine green; lymph node; robotic surgical procedure; stomach neoplasm