Journal article
Fluorescence to highlight the urethra - a human cadaveric study
- Abstract:
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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.
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).
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.
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.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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(Preview, Version of record, pdf, 1.2MB, Terms of use)
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- Publisher copy:
- 10.1007/s10151-017-1615-y
Authors
- Publisher:
- Spinger Verlag
- Journal:
- Techniques in Coloproctology More from this journal
- Volume:
- 21
- Issue:
- 6
- Pages:
- 439-444
- Publication date:
- 2017-05-30
- Acceptance date:
- 2017-02-27
- DOI:
- EISSN:
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1128-045X
- ISSN:
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1123-6337
- Keywords:
- Pubs id:
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pubs:686459
- UUID:
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uuid:d90a89dd-35fb-4c57-a7c3-07c707513b6e
- Local pid:
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pubs:686459
- Source identifiers:
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686459
- Deposit date:
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2017-03-21
Terms of use
- Copyright holder:
- © Barnes, et al 2017
- Copyright date:
- 2017
- Notes:
- This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
- Licence:
- CC Attribution (CC BY)
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