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Applications in Adrenal Surgery

  • Bora Kahramangil
  • Eren BerberEmail author
Chapter
  • 16 Downloads

Abstract

Minimally invasive adrenalectomy has become the standard of care for the treatment of adrenal tumors. A successful adrenalectomy requires the identification of the adrenal tumor in the retroperitoneal fat as well as emphasizing the correct dissection plane throughout the dissection. Although laparoscopic ultrasound has been increasingly used for this purpose, it heavily relies on a good contact between the ultrasound probe and the retroperitoneal tissues. This can limit its usefulness in patients with difficult anatomy. Indocyanine green (ICG) fluorescence imaging has recently been described as an intraoperative tool that does not require tissue contact. It involves the intravenous administration of ICG intraoperatively and the use of near-infrared fluorescence systems to visualize the resulting fluorescence. Such systems are available for both laparoscopic and robotic platforms. This chapter describes the use of this technology in a robotic platform and discusses its strengths and limitations based on a literature review and institutional expertise.

Keywords

Robotic adrenalectomy ICG Indocyanine green Fluorescence imaging Literature review 

Supplementary material

Video 3.1

Video clip describing the performance of indocyanine green-guided robotic lateral transabdominal adrenalectomy for a left-sided adrenal lesion (MP4 584634 kb)

References

  1. 1.
    Gagner M, Lacroix A, Bolte E. Laparoscopic adrenalectomy in Cushing’s syndrome and pheochromocytoma. N Engl J Med. 1992;327(14):1033.CrossRefGoogle Scholar
  2. 2.
    Chen Y, Scholten A, Chomsky-Higgins K, Nwaogu I, Gosnell JE, Seib C, et al. Risk factors associated with perioperative complications and prolonged length of stay after laparoscopic adrenalectomy. JAMA Surg. 2018;153(11):1036–41.CrossRefGoogle Scholar
  3. 3.
    Kahramangil B, Berber E. Comparison of posterior retroperitoneal and transabdominal lateral approaches in robotic adrenalectomy: an analysis of 200 cases. Surg Endosc. 2018;32(4):1984–9.CrossRefGoogle Scholar
  4. 4.
    Colvin J, Zaidi N, Berber E. The utility of indocyanine green fluorescence imaging during robotic adrenalectomy. J Surg Oncol. 2016;114(2):153–6.CrossRefGoogle Scholar
  5. 5.
    Manny TB, Pompeo AS, Hemal AK. Robotic partial adrenalectomy using indocyanine green dye with near-infrared imaging: the initial clinical experience. Urology. 2013;82(3):738–42.CrossRefGoogle Scholar
  6. 6.
    Hope-Ross M, Yannuzzi LA, Gragoudas ES, Guyer DR, Slakter JS, Sorenson JA, et al. Adverse reactions due to indocyanine green. Ophthalmology. 1994;101(3):529–33.CrossRefGoogle Scholar
  7. 7.
    Kahramangil B, Kose E, Berber E. Characterization of fluorescence patterns exhibited by different adrenal tumors: determining the indications for indocyanine green use in adrenalectomy. Surgery. 2018;164(5):972–7.CrossRefGoogle Scholar
  8. 8.
    DeLong JC, Chakedis JM, Hosseini A, Kelly KJ, Horgan S, Bouvet M. Indocyanine green (ICG) fluorescence-guided laparoscopic adrenalectomy. J Surg Oncol. 2015;112(6):650–3.CrossRefGoogle Scholar
  9. 9.
    Sound S, Okoh AK, Bucak E, Yigitbas H, Dural C, Berber E. Intraoperative tumor localization and tissue distinction during robotic adrenalectomy using indocyanine green fluorescence imaging: a feasibility study. Surg Endosc. 2016;30(2):657–62.CrossRefGoogle Scholar
  10. 10.
    Taskin HE, Berber E. Robotic adrenalectomy. Cancer J. 2013;19(2):162–6.CrossRefGoogle Scholar
  11. 11.
    Kahramangil B, Berber E. The use of near-infrared fluorescence imaging in endocrine surgical procedures. J Surg Oncol. 2017;115(7):848–55.CrossRefGoogle Scholar
  12. 12.
    Aoki T, Murakami M, Yasuda D, Shimizu Y, Kusano T, Matsuda K, et al. Intraoperative fluorescent imaging using indocyanine green for liver mapping and cholangiography. J Hepatobiliary Pancreat Sci. 2010;17(5):590–4.CrossRefGoogle Scholar
  13. 13.
    Piazza L, Caragliano P, Scardilli M, Sgroi AV, Marino G, Giannone G. Laparoscopic robot-assisted right adrenalectomy and left ovariectomy (case reports). Chir Ital. 1999;51(6):465–6.PubMedGoogle Scholar
  14. 14.
    Hubens G, Ysebaert D, Vaneerdeweg W, Chapelle T, Eyskens E. Laparoscopic adrenalectomy with the aid of the AESOP 2000 robot. Acta Chir Belg. 1999;99(3):125–7; discussion 7-9.PubMedGoogle Scholar
  15. 15.
    Arora E, Bhandarwar A, Wagh A, Gandhi S, Patel C, Gupta S, et al. Role of indo-cyanine green (ICG) fluorescence in laparoscopic adrenalectomy: a retrospective review of 55 cases. Surg Endosc. 2018;32(11):4649–57.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Department of General SurgeryCleveland Clinic FloridaWestonUSA
  2. 2.Department of General Surgery and Endocrine SurgeryCleveland ClinicClevelandUSA

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