A novel wireless wearable fluorescence image-guided surgery system.

Abstract

Segmentectomy using indocyanine green (ICG) has become a primary treatment option to achieve a complete resection and preserve lung function in early-stage lung cancer. However, owing to a lack of appropriate intraoperative imaging systems, it is a huge challenge for surgeons to identify the intersegmental plane during the operation, leading to poor prognosis. Thus, we developed a novel wireless wearable fluorescence image-guided surgery system (LIGHTEN) for fast and accurate identification of intersegmental planes in human patients. The system consists of a handle, light source, Google glass and laptop. Application software is written to capture clear real-time images and Google glass is adopted to display with augmented reality. Twelve in vivo studies of pulmonary segmentectomy in swine by intravenous injection of ICG were conducted to test the performance of the system. A distinct black-and-white transition zone image was observed and displayed simultaneously on the Google glass in all swine. The results demonstrated that surgeons using LIGHTEN can effortlessly and quickly discern intersegmental planes during the operation. Our system has enormous potential in helping surgeons to precisely identify intersegmental planes with mobility and high-sensitivity.