Fluorescence Guided Surgery

The definitive textbook on state-of-the-art fluorescence-guided neurosurgery Advances in fluorescence-guided surgery (FGS) have resulted in a paradigm shift in neurosurgical approaches to neuro-oncological and cerebrovascular pathologies. Edited by two of the foremost authorities on the topic, Fluorescence-Guided Neurosurgery: Neuro-oncology and Cerebrovascular Applications encompasses the depth and breadth of this groundbreaking, still nascent technology. The book reflects significant contributions made by world renowned neurosurgeons Constantinos Hadjipanayis, Walter Stummer, and esteemed contributors on the growing uses of 5-aminolevulinic acid (5-ALA) and other FGS agents. The European Medicine Agency approved 5-ALA in 2007, heralding the birth of FGS globally. In 2017, the U.S. Food and Drug Administration approved 5-ALA (Gleolan) as an imaging agent to facilitate realtime detection and visualization of malignant tissue during glioma surgery. In the two decades since Dr. Stummer's initial description of 5-ALA FGS in a human patient, major strides have been made in its practical applications, leading to improved resection outcomes. As FGS is increasingly incorporated into neurosurgical practice, it holds promise for future innovations. Generously-illustrated and enhanced with online videos, this textbook is the definitive resource on the subject. Key Features The improved efficacy of 5-ALA for resecting high- and low-grade gliomas, recurrences, meningiomas, brain metastases, spinal cord tumors, pediatric brain tumors, and other adult tumors The future of fluorescence, including potentially powerful new fluorophores molecularly targeted specifically to tumors The use of the fluorescent agent indocyanine green (ICG) for brain tumors, cerebral aneurysms, AVMs, and cerebral vascularization Special topics such as fluorescein, illuminating tumor paint, confocal microscopy, Raman spectroscopy, and integrating FGS with intraoperative imaging and brain mapping This single accessible reference presents the current state-of-the-art on this emerging, exciting surgical technology. As such, it is a must-have for neurosurgical residents, fellows, and practicing neurosurgeons.

This volume is a practical guide of theranostics using intraoperative fluorescence imaging technology, as an all-out effort by the Japanese Society for Fluorescence Guided Surgery. It describes the various approaches the technique is being used such as vascular imaging, identification of lymphatic vessels by intratissue injection, lymph node imaging, and imaging for identification of anatomical structures. The book is organized into three major parts and the first one delivers the basics, introducing the use of the technology in clinical settings and initial setups. Next comes the description of clinical applications where chapters illustrate perfusion assessment, cancer localization, anatomy visualization, and lymph nodes/ducts mapping. Each chapter is devoted to the specific surgical field and disease areas, presenting images and videos of case studies. The last part presents some upcoming techniques for treatments. The Editor and the authors wish the ideas presented here will be hints to bridge the knowledge between surgeons and basic researchers for further innovation and practicality. It is important to stay up-to-date since intraoperative fluorescence imaging has been applied to clinical settings in various surgical fields and at the same time, novel techniques improving the efficacy of the technology have also been developed actively. Fluorescence-Guided Surgery – From Lab to Operation Room is recommended for surgeons, operating nurses, medical experts, basic researchers and, industry engineers worldwide beyond boundaries of specialties. Edited and written by experts of The Japanese Society for Fluorescence-Guided Surgery, those who are the founders of the technology, it describes the accurate development history and cutting-edge techniques based on the knowledge accumulated over the years. ​

Strategies for Curative Fluorescence-Guided Surgery of Cancer is the first book to discuss how fluorescence-guided surgery can be successfully used during surgeries with several tumor types. FGS is one of the most exciting emerging modalities of surgery, especially cancer surgery, as it potentially allows the surgeon to visualize the actual margin of the tumor, thus greatly increasing the possibility of curative resection. The book discusses the applicability of FGS for several types of cancer, such as pancreatic cancer, liver metastasis, soft-tissue sarcoma, glioma, melanoma, and breast and lung cancer. This book is a valuable resource for cancer surgeons, cancer researchers and members of several other areas in the biomedical field who are interested in understanding this powerful technique. Presents an overview of fluorescence-guided surgery Explains general strategies for curative fluorescence-guided surgery and their applicability for each major tumor type Discusses the current and future achievements of FGS as a precise technique for cancer surgeries

Fluorescence-guided surgery (FGS) is a type of surgery that is performed with the guidance of fluorescence imaging. It has emerged as a new approach to detect the primary tumor, tumor margins, and metastatic lymph nodes. A major cause of tumor recurrence is the presence of residual tumor cells after surgery. Therefore, it is necessary to have a negative tumor margin to ensure a successful cancer resection. Despite widespread use of preoperative imaging techniques such as computed tomography (CT) scan, magnetic resonance imaging (MRI) scan, and positron emission tomography (PET) scan, the surgical margin positive rate failed to reflect remarkable improvement. The plausible reason for this failure is the reliance of surgeons on the visual inspection and intraoperative histopathological analysis of the frozen tissue specimen. FGS is now emerging as an effective tool to guide the surgical oncologists by generating real time fluorescence images of the surgical region. It reduces the possibility of recurrence of cancer. This book strives to provide a fair idea about the fluorescence-guided surgery and to help develop a better understanding of the latest advances related to this medical procedure. It is a vital tool for all researching and studying fluorescence-guided surgery as it gives incredible insights into the emerging trends and concepts.

Fluorescence-guided surgery (FGS) is defined as a medical imaging technique that uses a fluorescent dye or a near-infrared emitting light source to identify anatomic structures during surgical procedures. In 2020 alone, over 1200 academic articles were published on the topic of fluorescence-guidance surgery, a sign that this modality is making significant inroads into surgical practice. The use of near-infrared imaging and FGS is a rapidly growing modality, allowing surgeons to see more intraoperatively, enhance surgical precision, and improve surgical decision-making and patient outcomes. This manual provides a comprehensive, state-of-the art review of this field and will serve as a valuable resource for clinicians, surgeons and researchers with an interest in fluorescence-guided surgery, guiding patient management and stimulating investigative efforts. After initial chapters discussing the history of FGS and the current platforms and devices, it presents the most up-to-date data regarding the use of FGS in multiple surgical fields - colorectal, hepatic, endocrine, reconstructive, pediatric, among others - as well as in the treatment of specific conditions such as burns. Chapters are generously illustrated with full-color figures and intraoperative photographs, and selected chapters include video segments. Access to a comprehensive resource such as this is currently limited by the relatively new inroads that fluorescence-guided technology has made into surgery. The SAGES Manual of Fluorescence-Guided Surgery fills this gap in the literature.

This book presents a comprehensive overview and outlook for the future of indocyanine green (ICG) fluorescence navigation surgery, which is attracting clinical interest as a safe and less invasive procedure not only in detecting cerebral vessels, coronary arteries, and biliary trees, but also in identifying sentinel lymph nodes in cancer. The book starts with the characteristics of ICG and photodynamic cameras/endoscopes, followed by detailed descriptions of the applications of ICG fluorescence imaging in various areas such as ocular surgery, neurosurgery, cardiovascular surgery, and plastic surgery. It also covers identifying sentinel lymph nodes in breast cancer as well as cancers of the gastrointestinal tract, and provides valuable information for hepato-biliary-pancreatic surgeons, such as identifying tattooing of liver segments and bile leakage. Written entirely by experts in their respective areas, ICG Fluorescence Imaging and Navigation Surgery offers an essential resource for surgeons operating on cancers and vascular disorders in the brain and cardiovascular systems and in plastic surgery.

​This book provides a trove of insightful perspectives on the current state and the realization of digital surgery. Digital surgery entails the application of artificial intelligence and machine learning toward automation in robotic-assisted surgery. More generally, the objective is to digitally define the patient, the surgical field, and the surgical problem or task at hand; to operate based on information, rather than based on anatomic planes alone. But digital surgery has shapeshifted into other, equally intriguing faces – many of which are exemplified by topics throughout this book. Digital surgery is fundamental to 3D-printed organs, mind-controlled limbs, image-guided navigation, and tele-mentoring. It is the key that unlocks the metaphorical doorway to surgical access, thereby creating a global framework for surgical training, education, planning, and much more. This text provides methods of measurement and perception outside of the human umwelt – including the ability to visualize fields beyond the visible light spectrum, via near infrared fluorescent organic dyes which are rapidly being bioengineered to target specific tumors, as well as native anatomic structures of interest. Written by experts in the field, Digital Surgery is designed to help surgeons operate with an enriched understanding of an individual’s specific attributes: including the human phenome, physiome, microbiome, genome, and epigenome. It also aids surgeons in harnessing the power and fluidity of the cloud, which is emerging as a significant resource for surgeons both regionally and globally.

In addition to surgery and radiotherapy, local treatment modalities for the management of brain tumours are increasingly being developed and clinically tested. This book describes for the first time basic tumour biology as well as all current procedures in progress at the most recent level of knowledge, presented by leading experts in the respective fields. Image guided resection procedures, fluorescence guided surgery, developments in interstitial radiosurgery are addressed, just as intracavitary chemotherapy and all current concepts and studies of interstitial targeted therapy. Owing to its topicality this book will remain for long the standard for this comprehensively treated subject.