Visualizing the lymphatic system with ICG in tumor surgery*
The KARL STORZ Near Infrared (NIR/ICG) system and the marker indocyanine green (ICG) enables non-radioactive visualization of the entire lymphatic system surrounding a tumor in real time, e.g., in a laparoscopic manner.
The system offers the following advantages:
- Non-radioactive lymph node detection method
- Multidisciplinary use
- Xenon-based technology (no laser safety measures necessary)
- Intuitive switchover between standard white light and fluorescence mode via footswitch
- Physicians describe their surgical experience with the system as follows: The NIR/ICG system allows the reduction of radical lymphadenectomy and, at the same time, visual control makes the en-bloc resection of lymph nodes easier.
*The intradermal administration of indocyanine green for (S)LN has already been approved in Italy (breast cancer), Japan and Russia. Please inform yourself in advance about the potential for the off-label use of ICG in your hospital / country.
Laparoscopic visualization of the lymphatic system in gynecology with the NIR/ICG system
In gynecology, the degree of tumor involvement in the sentinel lymph node (SLN) is of great importance as it provides medical information about the tumor stage and is thus one of the main prognostic factors. In breast cancer surgery, SLN detection with the radioactive tracer 99mTc is the gold standard. In other areas of gynecological tumor surgery, its benefits in comparison to elective lymph node dissection is the subject of discussion. As a new, non-radioactive imaging technique, NIR imaging with ICG can provide a useful contribution to this field.1 SLN mapping of endometrial carcinoma yielded the following results (radioactive tracer 99mTc vs. ICG):
Radioactive Tracer 99mTc
Total SLN detection rate
|Study 12||83 %||61 %||95,5 %||95,5 %|
1 Papadia et al., Doctor-to-Doctor Manual ENDO-PRESS®, ICG-enhanced Fluorescence-guided SLN Mapping in Gynecological Malignancies (ISBN 978-3-89756-932-4)
2 Imboden et al., Surg. Oncol. 2015
VITOM® II ICG – Use for vulvar carcinoma
The VITOM® II ICG from KARL STORZ provides an optimal solution for the sentinel lymph node mapping in the case of vulvar carcinoma. VITOM® II ICG is an exoscope that combines the benefits of both endoscopy and microscopy. It is used with the same camera system that is employed in endoscopy (IMAGE1 S NIR system).
- NIR visualization with the VITOM® II ICG – in addition to technetium and blue dye – offers the surgeon a straightforward method for the detection and selective removal of sentinel lymph nodes (SLN) in the case of vulvar carcinoma
- Possibility for the integration of an exoscope by means of a holding arm into the gynecologist’s operating field