You have accessJournal of UrologyProstate Cancer: Staging II1 Apr 2016MP79-08 INTRAOPERATIVE FLUORESCENCE IMAGING WITH INDOCYANINE GREEN FOR SENTINEL LYMPH NODES FOR PROSTATE CANCER DURING LAPAROSCOPIC RADICAL PROSTATECTOMY JUN MIKI, Takafumi Yanagisawa, Fumihiko Urabe, Keiji Yasue, Taro Igarashi, Hayato Shimada, Takahiro Kimura, Hiroyuki Takahashi, Kouichi Kishimoto, and Shin Egawa JUN MIKIJUN MIKI More articles by this author , Takafumi YanagisawaTakafumi Yanagisawa More articles by this author , Fumihiko UrabeFumihiko Urabe More articles by this author , Keiji YasueKeiji Yasue More articles by this author , Taro IgarashiTaro Igarashi More articles by this author , Hayato ShimadaHayato Shimada More articles by this author , Takahiro KimuraTakahiro Kimura More articles by this author , Hiroyuki TakahashiHiroyuki Takahashi More articles by this author , Kouichi KishimotoKouichi Kishimoto More articles by this author , and Shin EgawaShin Egawa More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2006AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To investigate the feasibility of visualizing of sentinel lymph node (SLN) and lymphatic pathway by intraoperative fluorescence imaging with indocyanine green (ICG) during laparoscopic radical prostatectomy (LRP). METHODS From January 2014 to September 2015, LRP was performed in 28 patients with clinically localized, intermediate-risk or high-risk prostate cancer. ICG was injected into the prostate via transrectal ultrasound guidance 30 minutes before surgery. Intraoperative fluorescence imaging was performed using a near-infrared camera system. After ICG was allowed to travel through the pelvic lymphatics, extended lymphadenectomy was performed. We used the Olympus near infrared laparoscopic imaging system for ICG fluorescence observation. RESULTS SLNs were identified in 27 patients (96.4%). One-hundred thirty-eight SLNs were removed (median 4.9 SLNs per patient, range 0-14). The incidences of lymph node metastasis were 10.7% (3/28), and a total of 15 tumor-positive nodes was found: 6 SLNs and 9 no- SLNs. In 2 patients, the SLN was the only tumor-positive node. In particular, of the only tumor-positive SLNs, all nodes were found in internal iliac and obturator packet. On a per-patient basis, the sensitivity of the SLN biopsy procedure was 100%. Three characteristic lymphatic pathway patterns were also identified, and the predominant pattern was that the lymph vessels originating from the prostate run alongside the medial umbilical ligament and continue laterally to internal iliac, obturator, and external iliac (Figure 1). No complications or anaphylactic reactions occurred. CONCLUSIONS Intraoperative fluorescence imaging with ICG during LRP is feasible and safe for identification of SLN. One advantage of this technique is that it allows real time visualization of lymphatic vessels and intraoperative lymph node detection without radioisotope. The internal iliac and obturator lymph nodes should be invariably dissected for accurate pathological staging especially in low-volume nodal involvement. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e1037 Advertisement Copyright & Permissions© 2016MetricsAuthor Information JUN MIKI More articles by this author Takafumi Yanagisawa More articles by this author Fumihiko Urabe More articles by this author Keiji Yasue More articles by this author Taro Igarashi More articles by this author Hayato Shimada More articles by this author Takahiro Kimura More articles by this author Hiroyuki Takahashi More articles by this author Kouichi Kishimoto More articles by this author Shin Egawa More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...