Outpatient Surgery Magazine

Unsung Heroes - November 2019 - Subscribe to Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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gical monitors from inside the body can brighten up a dark cavity, but beyond brightness it doesn't provide any additional assistance or usable information to the surgeon. The ultra-high resolution of a 4K monitor can definitely enhance the quality of visualization, but on its own it doesn't assist the surgeon beyond showing a very crisp real-life picture. That's where the more intelligent visualization offered by near- infrared fluorescence imaging can provide a tremendous assist to the surgeon. Using invisible near-infrared light, it identifies and delineates areas of interest. It can, for example, help a surgeon distinguish unhealthy tissue from healthy tissue through enhanced color contrast. The technology can contribute to surgeons performing more confi- dent, accurate and comprehensive procedures, especially those involving the identification and removal of cancerous tumors. "Surgeons don't have anything to guide them through the surgical resection of bad tissue," says Maged Henary, PhD, an associate profes- sor of chemistry and associate director of graduate studies at Georgia State University in Atlanta. "Sometimes surgeons like to cut a larger amount of tissue than is necessary. They don't know really how many small parts of the tumor may have been left behind." Invisible to the naked eye, near-infrared light provides "lighting" for the surgeon that visible white light can't. That lighting is enabled by a contrast agent, or fluorophore. The wavelength of the near-infrared light excites the contrast agent that has bonded with the tissue. Malignant tissue fluoresces differently than benign tissue. The imaging system can then overlay easily distinguishable colors onto a normal operative view that highlights critical areas. The most commonly used contrast agent is indocyanine green (ICG), and the only other FDA-approved agent is methylene blue. Arguments in favor of near-infrared fluorescence center around case reports and anecdotes, according to Christopher Schlachta, MD, a pro- N O V E M B E R 2 0 1 9 • O U T PA T I E N T S U R G E R Y. N E T • 6 9

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