دورية أكاديمية
A DROP-IN Gamma Probe for Robot-assisted Radioguided Surgery of Lymph Nodes During Radical Prostatectomy.
العنوان: | A DROP-IN Gamma Probe for Robot-assisted Radioguided Surgery of Lymph Nodes During Radical Prostatectomy. |
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المؤلفون: | Dell'Oglio P; Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands; ORSI Academy, Melle, Belgium; Department of Urology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands; Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy., Meershoek P; Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands; Department of Urology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands., Maurer T; Martini-Clinic, University Medical Center Hamburg-Eppendorf, Hamburg, Germany., Wit EMK; Department of Urology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands., van Leeuwen PJ; Department of Urology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands., van der Poel HG; Department of Urology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands., van Leeuwen FWB; Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands; ORSI Academy, Melle, Belgium; Department of Urology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands., van Oosterom MN; Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands; Department of Urology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. Electronic address: m.n.van_oosterom@lumc.nl. |
المصدر: | European urology [Eur Urol] 2021 Jan; Vol. 79 (1), pp. 124-132. Date of Electronic Publication: 2020 Nov 14. |
نوع المنشور: | Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Video-Audio Media |
اللغة: | English |
بيانات الدورية: | Publisher: Elsevier Science Country of Publication: Switzerland NLM ID: 7512719 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-7560 (Electronic) Linking ISSN: 03022838 NLM ISO Abbreviation: Eur Urol Subsets: MEDLINE |
أسماء مطبوعة: | Publication: 2002- : Amsterdam : Elsevier Science Original Publication: Basel, New York, Karger. |
مواضيع طبية MeSH: | Laparoscopy* , Radiosurgery* , Robotic Surgical Procedures*, Lymph Node Excision/*methods , Prostatectomy/*methods , Prostatic Neoplasms/*surgery, Aged ; Fluorescence ; Humans ; Lymphatic Metastasis ; Male ; Prostatic Neoplasms/pathology |
مستخلص: | Background: The DROP-IN gamma probe was introduced to overcome the restricted manoeuvrability of traditional laparoscopic gamma probes. Through enhanced manoeuvrability and surgical autonomy, the DROP-IN promotes the implementation of radioguided surgery in the robotic setting. Objective: To confirm the utility and safety profile of the DROP-IN gamma probe and to perform a comparison with the traditional laparoscopic gamma probe and fluorescence guidance. Design, Setting, and Participants: Twenty-five prostate cancer patients were scheduled for a robot-assisted sentinel lymph node (SN) procedure, extended pelvic lymph node dissection, and prostatectomy at a single European centre. Surgical Procedure: After intraprostatic injection of indocyanine green (ICG)- 99m Tc-nanocolloid (n = 12) or 99m Tc-nanocolloid + ICG (n = 13), SN locations were defined using preoperative imaging. Surgical excision of SNs was performed under image guidance using the DROP-IN gamma probe, the traditional laparoscopic gamma probe, and fluorescence imaging. Measurements: Intraoperative SN detection was assessed for the different modalities and related to anatomical locations. Patient follow-up was included (a median of 18 mo). Results and Limitations: Overall, 47 SNs were pursued in vivo by the DROP-IN gamma probe, of which 100% were identified. No adverse events related to its use were observed. In vivo fluorescence imaging identified 91% of these SNs. The laparoscopic gamma probe identified only 76% of these SNs, where the detection inaccuracies appeared to be related to specific anatomical regions. Conclusions: Owing to improved manoeuvrability, the DROP-IN probe yielded improved SN detection rates compared with the traditional gamma probe and fluorescence imaging. These findings underline that the DROP-IN technology provides a valuable tool for radioguided surgery in the robotic setting. Patient Summary: Radioguided robot-assisted surgery with the novel DROP-IN gamma probe is feasible and safe. It enables more efficient intraoperative identification of sentinel lymph nodes than can be achieved with a traditional laparoscopic gamma probe. The use of the DROP-IN probe in combination with fluorescence imaging allows for a complementary optical confirmation of node localisations. (Copyright © 2020 The Author(s). Published by Elsevier B.V. All rights reserved.) |
فهرسة مساهمة: | Keywords: Fluorescence imaging; Gamma probe; Image-guided surgery; Prostate cancer; Radioguided surgery; Robotic surgery; Sentinel lymph node |
تواريخ الأحداث: | Date Created: 20201118 Date Completed: 20210927 Latest Revision: 20210927 |
رمز التحديث: | 20240628 |
DOI: | 10.1016/j.eururo.2020.10.031 |
PMID: | 33203549 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1873-7560 |
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DOI: | 10.1016/j.eururo.2020.10.031 |