Category: Other, Miscellaneous

VS12-12 - Laparoscopic surgery for small intra-abdominal tumor under preoperative computed tomography-guided marking with a mixture of indocyanine green and lipiodol

Sat, Sep 22
2:00 PM - 4:00 PM

Introduction & Objective :

Preoperative computed tomography-guided marking with the dye is used for detection of small tumor. However there is a problem that the dye diffuses in a short time. We used mixture of indocyanine green and lipiodol to prevent the dye from diffusing.


Methods : The patient was underwent laparoscopic nephrectomy for renal cell carcinoma and laparoscopic splenectomy for hemangioma. 11 monthts after surgery, we diagnosed the growing tumor with computed tomography in the paravertebral region. The tumor size was 12mm diameter. Suspected of recurrence of renal cell carcinoma, we decided to perform laparoscopic tumorectomy. The tumor was suspected to be difficult to localize so we performed preoperative computed tomography-guided marking. Indocyanine green was used as a dye and lipiodol was used to prevent the dye from diffusing. Injection was performed around the tumor 42 hours before surgery. We used the endoscope with a camera imaging head containing a fluorescence imaging system during surgery.


Results :

The operative time was 117 minutes, and the estimated blood loss was 0ml.  No intraoperative complications were encountered. Although 42 hours had elapsed from the insertion, the image of indocyanine green was good. The histopathological diagnosis was accessory spleen. A micro accessory spleen was increased by removing the spleen. The postoperative course was uneventful.


Conclusions :

Preoperative computed tomography-guided marking with a mixture of indocyanine green and lipiodol is useful of laparoscopic surgery for small intra-abdominal tumor. 

Yuki Okinaka

Research associate
Shiga university of medical science
Otsu, Shiga, Japan

Tetsuya Yoshida

Research associate
Shiga university of medical science
Otsu, Shiga, Japan

Susumu Kageyama

Lecturer
The department of urology, Shiga university of medical science
Otsu city, Shiga, Japan

Mitsuhiro Narita

Associate proffessor
The department of urology, Shiga university of medical science
Otsu City, Shiga, Japan

Akihiro Kawauchi

Professor
The department of urology, Shiga university of medical science
Otsu, Shiga, Japan