TY - JOUR
T1 - Real-time ureteral identification with novel, versatile, and inexpensive catheter
AU - Ushimaru, Yuki
AU - Ohigawa, Atsushi
AU - Yamashita, Kotaro
AU - Saito, Takuro
AU - Tanaka, Koji
AU - Makino, Tomoki
AU - Takahashi, Tsuyoshi
AU - Kurokawa, Yukinori
AU - Yamasaki, Makoto
AU - Mori, Masaki
AU - Doki, Yuichiro
AU - Nakajima, Kiyokazu
PY - 2020/8/1
Y1 - 2020/8/1
N2 - Background: Although ureteral catheters and ureteral fluorescence methods have been investigated to avoid ureteral injury, they have not been standardized for procedural complexity and safety to the living body. A near-infrared (NIR) fluorescence ureteral catheter made of fluorescent resin was jointly developed for non-invasive detection of ureters. The aims of this study were to (1) evaluate its bench-top performance and (2) assert its safety and potential usefulness in a series of animal models. Methods: [Bench-top study]: Confirmed stimulation of NIR fluorescence catheter by NIR light was investigated with the use of a laparoscopic fluorescence imaging system. Additionally, the influence of imaging distance and shielding objects, such as 1.5-mm sliced pig loin with multiple sheets, was also evaluated. [Performance study]: The safety and potential usefulness of fluorescence catheter was evaluated in five pigs. Non-fluorescence and fluorescence ureteral catheters were alternatively placed in the animals’ left and right ureters. The ImageJ software was used in all experiments to quantify fluorescence signal and the signal-to-background ratio. Results: [Bench-top study]: The fluorescence ureteral catheter was successfully identified at all distances. Its fluorescence decreased in inverse proportion to distance and to the intervening shield thickness (p < 0.01). When shields were present, catheter position could not be recognized with non-fluorescence catheters, but with fluorescence catheters they could be recognized. [Performance study]: Fluorescence catheter’s ability to fluoresce at all distances was confirmed (p < 0.01). No individual differences (p = 0.21) or left/right ureter differences (p = 0.79) were observed. The fluorescence of the fluorescence catheter decreased in inverse proportion to distance (p < 0.01). Conclusions: The new fluorescence ureter catheter investigated shows promising performance in providing ureteral identification with high specificity during laparoscopic surgery.
AB - Background: Although ureteral catheters and ureteral fluorescence methods have been investigated to avoid ureteral injury, they have not been standardized for procedural complexity and safety to the living body. A near-infrared (NIR) fluorescence ureteral catheter made of fluorescent resin was jointly developed for non-invasive detection of ureters. The aims of this study were to (1) evaluate its bench-top performance and (2) assert its safety and potential usefulness in a series of animal models. Methods: [Bench-top study]: Confirmed stimulation of NIR fluorescence catheter by NIR light was investigated with the use of a laparoscopic fluorescence imaging system. Additionally, the influence of imaging distance and shielding objects, such as 1.5-mm sliced pig loin with multiple sheets, was also evaluated. [Performance study]: The safety and potential usefulness of fluorescence catheter was evaluated in five pigs. Non-fluorescence and fluorescence ureteral catheters were alternatively placed in the animals’ left and right ureters. The ImageJ software was used in all experiments to quantify fluorescence signal and the signal-to-background ratio. Results: [Bench-top study]: The fluorescence ureteral catheter was successfully identified at all distances. Its fluorescence decreased in inverse proportion to distance and to the intervening shield thickness (p < 0.01). When shields were present, catheter position could not be recognized with non-fluorescence catheters, but with fluorescence catheters they could be recognized. [Performance study]: Fluorescence catheter’s ability to fluoresce at all distances was confirmed (p < 0.01). No individual differences (p = 0.21) or left/right ureter differences (p = 0.79) were observed. The fluorescence of the fluorescence catheter decreased in inverse proportion to distance (p < 0.01). Conclusions: The new fluorescence ureter catheter investigated shows promising performance in providing ureteral identification with high specificity during laparoscopic surgery.
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U2 - 10.1007/s00464-019-07261-4
DO - 10.1007/s00464-019-07261-4
M3 - Article
C2 - 31907660
AN - SCOPUS:85077382204
VL - 34
SP - 3669
EP - 3678
JO - Surgical Endoscopy
JF - Surgical Endoscopy
SN - 0930-2794
IS - 8
ER -