Enhanced Reality and Intraoperative Imaging in Colorectal Surgery

Abstract Colorectal surgery is one of the most common procedures performed around the world with more than 600,000 operations each year in the United States, and more than a million worldwide. In the past two decades, there has been a clear trend toward minimal access and surgeons have embraced this evolution. Widespread adoption of advanced minimally invasive procedures is often limited by procedural complexity and the need for specific technical skills. Furthermore, the loss of 3D vision, limited overview of the surgical field, and diminished tactile sensation make major colorectal procedures more challenging and have an impact on the surgeons' learning curves. New technologies are emerging that can compensate for some of the sensory losses associated with laparoscopy. High-definition picture acquisition, 3D camera systems, and the use of biomarkers will allow improved identification of the target structures and help differentiate them from surrounding tissues. In this article, we describe some of the new technologies available and, in particular, focus on the possible implications of biomarkers and fluorescent laparoscopic imaging.

[1]  D. Winter,et al.  Complete mesocolic resection and extended lymphadenectomy for colon cancer: a systematic review , 2014, Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland.

[2]  C. Sakakura,et al.  Fluorescent detection of peritoneal metastasis in human colorectal cancer using 5-aminolevulinic acid , 2014, International journal of oncology.

[3]  Eduardo Fernandes,et al.  Indocyanine Green (ICG) Fluorescent Cholangiography During Robotic Cholecystectomy , 2014, Surgical innovation.

[4]  Giuseppe Spinoglio,et al.  The influence of fluorescence imaging on the location of bowel transection during robotic left-sided colorectal surgery , 2014, Surgical Endoscopy.

[5]  P. Morel,et al.  Three-dimensional laparoscopy: a new tool in the surgeon's armamentarium. , 2013, Surgical technology international.

[6]  Osman Ratib,et al.  Console-Integrated Stereoscopic OsiriX 3D Volume-Rendered Images for da Vinci Colorectal Robotic Surgery , 2013, Surgical innovation.

[7]  Steven D. Mills,et al.  The use of indocyanine green fluorescence to assess anastomotic perfusion during robotic assisted laparoscopic rectal surgery , 2013, Surgical Endoscopy.

[8]  U. Neumann,et al.  Comparison of Intestinal Microcirculation and Wound Healing in a Rat Model , 2013, Journal of investigative surgery : the official journal of the Academy of Surgical Research.

[9]  A. Laghi,et al.  Role of CT angiography with three-dimensional reconstruction of mesenteric vessels in laparoscopic colorectal resections: a randomized controlled trial , 2013, Surgical Endoscopy.

[10]  D. Sherwinter,et al.  Intra‐operative transanal near infrared imaging of colorectal anastomotic perfusion: a feasibility study , 2013, Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland.

[11]  Y. Sakai,et al.  Fluorescence diagnosis of metastatic lymph nodes using 5-aminolevulinic acid (5-ALA) in a mouse model of colon cancer. , 2012, The Journal of surgical research.

[12]  Rebecca C Fitzgerald,et al.  Molecular imaging using fluorescent lectins permits rapid endoscopic identification of dysplasia in Barrett's esophagus , 2012, Nature Medicine.

[13]  F. Ris,et al.  Near‐infrared laparoscopy for real‐time intra‐operative arterial and lymphatic perfusion imaging , 2011, Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland.

[14]  P. Low,et al.  Intraoperative tumor-specific fluorescence imaging in ovarian cancer by folate receptor-α targeting: first in-human results , 2011, Nature Medicine.

[15]  H. Ueno,et al.  Optimal margins and lymphadenectomy in colonic cancer surgery , 2011, The British journal of surgery.

[16]  Beth Friedman,et al.  Fluorescent peptides highlight peripheral nerves during surgery in mice , 2011, Nature Biotechnology.

[17]  K. Hasegawa,et al.  Fluorescent cholangiography illuminating the biliary tree during laparoscopic cholecystectomy , 2010, The British journal of surgery.

[18]  G. Maskell,et al.  The Angiographic Anatomy of the Small Arteries and Their Collaterals in Colorectal Resections: Some Insights Into Anastomotic Perfusion , 2010, Annals of surgery.

[19]  H. Harling,et al.  Anastomotic leakage after anterior resection for rectal cancer: risk factors , 2010, Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland.

[20]  Yoshinori Harada,et al.  Precise detection of lymph node metastases in mouse rectal cancer by using 5‐aminolevulinic acid , 2009, International journal of cancer.

[21]  Y. Shinozaki,et al.  Local VEGF Administration Enhances Healing of Colonic Anastomoses in a Rabbit Model , 2009, European Surgical Research.

[22]  Panayiotis A Kyriacou,et al.  Pulse oximetry and photoplethysmographic waveform analysis of the esophagus and bowel , 2008, Current opinion in anaesthesiology.

[23]  F. Zanella,et al.  Fluorescence-guided surgery with 5-aminolevulinic acid for resection of malignant glioma: a randomised controlled multicentre phase III trial. , 2006, The Lancet. Oncology.

[24]  Y. Ogawa,et al.  Preoperative assessment of vascular anatomy of inferior mesenteric artery by volume-rendered 3D-CT for laparoscopic lymph node dissection with left colic artery preservation in lower sigmoid and rectal cancer. , 2006, World journal of gastroenterology.

[25]  Can Ince,et al.  Quantifying bedside-derived imaging of microcirculatory abnormalities in septic patients: a prospective validation study , 2005, Critical care.

[26]  M. Raval,et al.  The Effects of Systemic Hypoxia on Colon Anastomotic Healing: An Animal Model , 2005, Diseases of the colon and rectum.

[27]  M. Braga,et al.  Altered microperfusion at the rectal stump is predictive for rectal anastomotic leak , 2000, Diseases of the colon and rectum.

[28]  H. L. Young,et al.  Determination of a critical level of tissue oxygenation in acute intestinal ischaemia. , 1992, Gut.

[29]  H. L. Young,et al.  Tissue oxygen tension as a predictor of colonic anastomotic healing , 1987, Diseases of the colon and rectum.

[30]  Ronan A. Cahill,et al.  Near-infrared (NIR) laparoscopy for intraoperative lymphatic road-mapping and sentinel node identification during definitive surgical resection of early-stage colorectal neoplasia , 2011, Surgical Endoscopy.

[31]  D. Silverman,et al.  Qualitative and quantitative fluorescein fluorescence in determining intestinal viability. , 1984, American journal of surgery.

[32]  D. Leaper Angiography as an index of healing in experimental laparotomy wounds and colonic anastomoses. , 1983, Annals of the Royal College of Surgeons of England.