2. Academic Validation
  3. Intraoperative ureter identification with a novel fluorescent catheter

Intraoperative ureter identification with a novel fluorescent catheter

  • Sci Rep. 2021 Feb 24;11(1):4501. doi: 10.1038/s41598-021-84121-z.
Manuel Barberio 1 2 3,  Mahdi Al-Taher 4 5,  Eric Felli 6,  Anila Hoskere Ashoka 7,  Jacques Marescaux 4,  Andrey Klymchenko 7,  Michele Diana 4 8
Affiliations

Affiliations

  • 1 Institute of Image-Guided Surgery, IHU-Strasbourg, 1, place de l'Hôpital, 67091, Strasbourg, France. manuel.barberio@ihu-strasbourg.eu.
  • 2 Research Institute Against Digestive Cancer, IRCAD, Strasbourg, France. manuel.barberio@ihu-strasbourg.eu.
  • 3 Ospedale Cardinale G. Panico, Tricase (LE), Italy. manuel.barberio@ihu-strasbourg.eu.
  • 4 Research Institute Against Digestive Cancer, IRCAD, Strasbourg, France.
  • 5 Maastricht University Medical Center, Maastricht, The Netherlands.
  • 6 Institute of Image-Guided Surgery, IHU-Strasbourg, 1, place de l'Hôpital, 67091, Strasbourg, France.
  • 7 Laboratoire de Bio-Imagerie et Pathologies, UMR 7021, CNRS, Université de Strasbourg, Strasbourg, France.
  • 8 iCube Laboratory, Photonics for Health, Strasbourg, France.
PMID: 33627768 DOI: 10.1038/s41598-021-84121-z
Abstract

Iatrogenic ureteral injuries (IUI) occur in 0.5-1.3% of cases during abdominal surgery. If not recognized intraoperatively, IUI increase morbidity/mortality. A universally accepted method to prevent IUI is lacking. Near-infrared fluorescent imaging (NIRF), penetrating deeper than normal LIGHT within the tissue, might be useful, therefore ureter visualization combining NIRF with special dyes (i.e. IRDye 800BK) is promising. Aim of this work is to evaluate the detection of ureters using stents coated with a novel biocompatible fluorescent material (NICE: near-infrared coating of equipment), during laparoscopy. female pigs underwent placement of NICE-coated stents (NS). NIRF was performed, and fluorescence intensity (FI) was computed. Successively, 0.15 mg/kg of IRDye 800BK was administered intravenously, and FI was computed at different timepoints. Ureter visualization using NS only was further assessed in a human cadaver. Both methods allowed in vivo ureter visualization, with equal FI. However, NS were constantly visible whereas IRDye 800BK allowed visualization exclusively during the ureteral peristaltic phases. In the human cadaver, NS provided excellent ureter visualization in its natural anatomical position. NS provided continuous ureteral visualization with similar FI as the IRDye 800BK, which exclusively allowed intermittent visualization, dependent on ureteral peristalsis. NS might prove useful to visualize ureters intraoperatively, potentially preventing IUI.

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