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 HOW I DO IT DIFFERENTLY
Year : 2021  |  Volume : 17  |  Issue : 4  |  Page : 576-579

Laparoscopic real-time vessel navigation using indocyanine green fluorescence during laparoscopy-assisted gastric tube reconstruction: First experience


1 Department of Gastroenterological Surgery II, Hokkaido University Graduate School of Medicine; Division of Minimally Invasive Surgery, Hokkaido University Hospital, Sapporo, Japan
2 Department of Gastroenterological Surgery II, Hokkaido University Graduate School of Medicine, Sapporo, Japan

Correspondence Address:
Dr. Yuma Ebihara
Division of Minimally Invasive Surgery, Hokkaido University Hospital, North 15 West 7, Kita-Ku, Sapporo 0608638, Hokkaido
Japan
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jmas.JMAS_210_20

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A considerable percentage of morbidity and mortality after oesophagectomy is due to leakage of oesophagogastrostomy, which is mainly caused by ischaemia of the gastric tube. Therefore, we performed laparoscopic real-time vessel navigation (LRTVN) using indocyanine green fluorescence (ICG) during laparoscopy-assisted gastric tube reconstruction (LAGR) to evaluate gastric tube blood flow and avoid vascular injury. This study included five oesophageal cancer patients who underwent video-assisted thoracoscopic oesophagectomy and LAGR. We confirmed the presence of the left gastroepiploic artery (LGEA) in all cases, and no findings such as post-operative gastric tube ischaemia were observed. In all cases, no vascular injury was observed, and the vascularization of LGEA was confirmed. This report is the first to consider the usefulness of LRTVN using ICG during LAGR. LRTVN using ICG during LAGR was considered to be useful for evaluating gastric tube blood flow and avoiding vascular injury around the splenic hiatus.






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