Visualization of cecal tumor by near-infrared laparoscopy and intraoperative colonoscopy

TL;DR

A new technique using near-infrared laparoscopy and colonoscopy helps surgeons accurately locate and remove cecal tumors during minimally invasive surgery.

Contribution

This is the first report of using near-infrared laparoscopy to visualize cecal tumor contours from outside the bowel during surgery.

Findings

Near-infrared laparoscopy successfully visualized a cecal tumor from outside the bowel.

The tumor was safely resected with a clear negative margin, confirmed by histopathology.

The technique is useful and safe for laparoscopic colorectal surgery involving endoscopy.

Abstract

In laparoscopic colorectal surgery, accurate localization of a tumor is essential for ensuring an adequate ablative margin. Therefore, a new method, near-infrared laparoscopy combined with intraoperative colonoscopy, was developed for visualizing the contour of a cecal tumor from outside of the bowel. The method was used after it was verified on a model that employed a silicone tube.

The patient was a 77-year-old man with a cecal tumor near the appendiceal orifice. Laparoscopy was used to clamp of the terminal ileum, and a colonoscope was then inserted through the anus to the cecum. The laparoscope in the normal light mode could not be used to identify the cecal tumor. However, a laparoscope in the near-infrared ray mode could clearly visualize the contour of the cecal tumor from outside of the bowel, and the tumor could be safely resected by a stapler. The histopathological diagnosis of the resected specimen was adenocarcinoma with an invasion depth of M and a clear negative margin.

This is the first report of the laparoscopic detection of the contour of a cecal tumor from outside the bowel. This technique is useful and safe for contouring tumors in laparoscopic colorectal surgery and can be used in various surgeries that combine endoscopy and laparoscopy.

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