Fluorescence to highlight the urethra - a human cadaveric study
<p>Purpose: Urethral injury is a feared complication of surgeons performing transanal TME (TaTME) or abdomino-perineal excision (APE) procedures. Injury during TaTME occurs when the prostate is inadvertently mobilised or as a direct injury similar to the direct injury during the perineal disse...
| Main Authors: | , , , |
|---|---|
| Format: | Journal article |
| Published: |
Spinger Verlag
2017
|
| Summary: | <p>Purpose: Urethral injury is a feared complication of surgeons performing transanal TME (TaTME) or abdomino-perineal excision (APE) procedures. Injury during TaTME occurs when the prostate is inadvertently mobilised or as a direct injury similar to the direct injury during the perineal dissection of APE procedures. This is a proof-in-principle study aiming to assess the feasibility of using ICG to fluoresce the urethra in human cadavers.</p> <p>Methods: Indocyanine green at varying doses was mixed with instillagel and infiltrated into the urethra of male human cadavers. The urethra was exposed through either a perineal incision or by mobilisation of the prostate during a TaTME dissection and fluorescence observed using a PINPOINT laparoscope (NOVADAQ). Brightness was assessed on the images using ImageJ (National Institute of Health).</p> <p>Results: Eight cadavers were included in the study. Fluorescence was visualised in the urethra in all 8 cadavers. Minimal dissection was required to obtain fluorescence trans-perineally. In one cadaver the urethra was demonstrated under fluorescence using a simulated TaTME with additional fluorescence also being observed in the prostate. There was no correlation between brightness and dosing.</p> <p>Conclusions: This novel proof of principle study demonstrates a simple way in which the urethra may be easily identified preventing it from injury during surgery.</p> |
|---|