COMPENDIUM ON AESCULAP® EinsteinVision® 3.0 FI

I GENERAL USE OF NEAR-INFRARED FLUORESCENCE IMAGING AND ICG SURGERY PAGE USE OF NEAR-INFRARED FLUORESCENCE IMAGING AND INDOCYANINE GREEN GUIDED SURGERY 6 - 8 SENTINEL LYMPH NODE MAPPING 46 - 49 PARTIAL PROSTATECTOMY, PARTIAL NEPHRECTOMY, PYELOPLASTY AND OTHERS 54 - 56

SEE BETTER. SEE BEYOND. EinsteinVision® 3.0 FI - 3D Fluorescence Imaging in real-time

TAKE A DIFFERENT LOOK AT ANATOMY Fluorescence Imaging (FI) aims for the best patient outcome during diagnostics or surgery.1 In minimally invasive surgery it is used in numerous applications such as vessel or visceral perfusion assessment, visualization of bile duct anatomy or (sentinel) lymph node mapping. ■ Shorter operating times using 3D technology2 ■ Clear view through integrated, controlled anti-fog function ■ Extended product life due to unique 3D sterile delivery concept3 ■ Extended system use, as both 2D and 3D camera heads can be connected to the visualization platform ■ Application...

GENERAL USE OF FLUORESCENCE IMAGING CONSENSUS CONFERENCE STATEMENT ON THE GENERAL USE OF NEAR-INFRARED FLUORESCENCE IMAGING AND INDOCYANINE GREEN GUIDED SURGERY Dip F., Boni L., Bouvet M., et al. Annals of Surgery, 2020, (modified Delphi study) BACKGROUND/AIM: In recent decades, the use of near-infrared light and fluorescence-guidance during open and laparoscopic surgery has exponentially expanded across various clinical settings. However, tremendous variability exists in how it is performed. In this first published survey of international experts on fluorescence-guided surgery, we sought to...

SURVEY RESULTS (CONSENSUS > 85%)1 Fundamentals of Fluorescent Imaging With ICG • In general, the use of fluorescence-guidance during surgery should be considered very safe. • In general, the use of ICG during fluorescence-guided surgery should be considered very safe. • Using fluorescence technology, with or without ICG, decreases or has no effect on the overall cost of a patient's peri- and postoperative care. • Fluorescence imaging, with and without ICG, should be part of routine surgical practice. • In general, the use of ICG should not be considered experimental. Patient selection • Prior...

GENERAL USE OF FLUORESCENCE IMAGING COULD FLUORESCENCE-GUIDED SURGERY BE AN EFFICIENT AND SUSTAINABLE OPTION? A SICE (ITALIAN SOCIETY OF ENDOSCOPIC SURGERY) HEALTH TECHNOLOGY ASSESSMENT SUMMARY Vettoretto, N., Foglia, E., Ferrario, L., et al. Surgical Endoscopy, 2020, (evaluation/comparative study) BACKGROUND/AIM: Indocyanine green fluorescence vision is an upcoming technology in surgery. It can be used in three ways: angiographic and biliary tree visualization and lymphatic spreading studies. The present paper shows the most outstanding results from an health technology assessment study design,...

GENERAL SURGERY CHOLECYSTECTOMY ABSTRACT COULD FLUORESCENCE-GUIDED SURGERY BE AN EFFICIENT AND SUSTAINABLE OPTION? A SICE (ITALIAN SOCIETY OF ENDOSCOPIC SURGERY) HEALTH TECHNOLOGY ASSESSMENT SUMMARY Vettoretto, N., Foglia, E., Ferrario, L., et al. Surgical Endoscopy, 2020, (evaluation/comparative study) BACKGROUND/AIM: Indocyanine green fluorescence vision is an upcoming technology in surgery. It can be used in three ways: angiographic and biliary tree visualization and lymphatic spreading studies. The present paper shows the most outstanding results from an health technology assessment study...

FLUORESCENCE OR X-RAY CHOLANGIOGRAPHY IN ELECTIVE LAPAROSCOPIC CHOLECYSTECTOMY: A RANDOMIZED CLINICAL TRIAL Lehrskov L.L., Westen M., Larsen S.S., et al. BJS, 2020, (randomized clinical trial) BACKGROUND/AIM: Safe laparoscopic cholecystectomy may necessitate biliary imaging, and non-invasive fluorescence cholangiography may have advantages over contrast X-ray cholangiography. This trial compared fluorescence and X-ray cholangiography for visualization of the critical junction between the cystic, common hepatic and common bile ducts. PATIENTS AND METHODS: This non-inferiority blinded RCT included...

GENERAL SURGERY CHOLECYSTECTOMY ABSTRACT RANDOMIZED TRIAL OF NEAR-INFRARED INCISIONLESS FLUORESCENT CHOLANGIOGRAPHY Dip F., LoMenzo E., Sarotto L., et al. Annals of Surgery, 2019, (multicenter randomized, single-blinded, controlled clinical trial) BACKGROUND/AIM: Incisionless near-infrared fluorescent cholangiography (NIFC) is emerging as a promising tool to enhance the visualization of extrahepatic biliary structures during laparoscopic cholecystectomies. PATIENTS AND METHODS: We conducted a single-blind, randomized, 2-arm trial comparing the efficacy of NIFC (n = 321) versus white light (WL)...

UNDERSTANDING INTRAOPERATIVE FLUORESCENT CHOLANGIOGRAPHY: TEN STEPS FOR AN EFFECTIVE AND SUCCESSFUL PROCEDURE Dip F., Aleman R., Frieder J.S., et al. Surgical Endoscopy, 2021, (retrospective study) BACKGROUND/AIM: Common bile duct injuries (BDI) during laparoscopic cholecystectomy (LC) continue to be the source of morbidity and mortality. The reason for BDI is mostly related to the misidentification of the extrahepatic bile duct structures and the anatomic variability. Near-infrared fluorescent cholangiography (NIFC) has proven to enhance visualization of extrahepatic biliary structures during...

GENERAL SURGERY CHOLECYSTECTOMY ABSTRACT FLUORESCENCE-BASED CHOLANGIOGRAPHY: PRELIMINARY RESULTS FROM THE IHU-IRCAD-EAES EURO-FIGS REGISTRY Agnus, V., Pesce, A., Boni, L. et al. Surgical Endoscopy, 2020 (registry study) BACKGROUND/AIM: Near-infrared fluorescence cholangiography (NIRF-C) is a popular application of fluorescence image-guided surgery (FIGS). NIRF-C requires near-infrared optimized laparoscopes and the injection of a fluorophore, most frequently Indocyanine Green (ICG), to highlight the biliary anatomy. It is investigated as a tool to increase safety during cholecystec-tomy. The...

DOES NEAR-INFRARED FLUORESCENT CHOLANGIOGRAPHY WITH INDOCYANINE GREEN REDUCE BILE DUCT INJURIES AND CONVERSIONS TO OPEN SURGERY DURING LAPAROSCOPIC OR ROBOTIC CHOLECYSTECTOMY? — A META-ANALYSIS Dip F., Lo Menzo E., White K.P., et al. Surgery - Infrared Fluorescence, 2021, (meta analysis) BACKGROUND/AIM: Bile duct injury and conversion-to-open–surgery rates remain unacceptably high during laparoscopic and robotic cholecystectomy. In a recently published randomized clinical trial, using near-infrared fluorescent cholangiography with indocyanine green intraoperatively markedly enhanced biliary-structure...