A case of laparoscopic sigmoidectomy using thermography for colonic blood flow assessment

Abstract Background Indocyanine green (ICG) fluorescence imaging is widely used in gastrointestinal surgery and is considered useful for reducing anastomotic leakage; however, because ICG remains in the tissue for a certain amount of time, we occasionally must re-evaluate colonic blood flow over a s...

Full description

Saved in:
Bibliographic Details
Main Authors: Tomohiro Kako, Masahiro Kimura, Ryo Nomura, Shuhei Uehara, Hiroshi Uematsu, Seiichi Nakaya, Yuzo Maeda, Ken Tsuboi, Koshiro Harata, Shuji Takiguchi
Format: Article
Language:English
Published: Japan Surgical Society 2023-09-01
Series:Surgical Case Reports
Subjects:
Online Access:https://doi.org/10.1186/s40792-023-01752-2
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849404511666307072
author Tomohiro Kako
Masahiro Kimura
Ryo Nomura
Shuhei Uehara
Hiroshi Uematsu
Seiichi Nakaya
Yuzo Maeda
Ken Tsuboi
Koshiro Harata
Shuji Takiguchi
author_facet Tomohiro Kako
Masahiro Kimura
Ryo Nomura
Shuhei Uehara
Hiroshi Uematsu
Seiichi Nakaya
Yuzo Maeda
Ken Tsuboi
Koshiro Harata
Shuji Takiguchi
author_sort Tomohiro Kako
collection DOAJ
description Abstract Background Indocyanine green (ICG) fluorescence imaging is widely used in gastrointestinal surgery and is considered useful for reducing anastomotic leakage; however, because ICG remains in the tissue for a certain amount of time, we occasionally must re-evaluate colonic blood flow over a short time period during surgery. Herein, we verify the usefulness of thermography (TG) for evaluating colonic blood flow in a patient who underwent a laparoscopic sigmoidectomy for sigmoid colon cancer. Case presentation The patient is 43-year-old man who underwent laparoscopic resection of the sigmoid colon for colon cancer. After vascular treatment of the colonic mesentery, ICG/TG identified the boundary between ischemic and non-ischemic colon tissues. An additional 2 cm of colonic mesentery was resected because of the presence of a diverticulum noted at the intended site of oral anastomosis when attaching the anvil head. After additional vascular treatment of the colonic mesentery and administration of ICG, fluorescence was observed in the colon; however, TG identified the zone of the temperature transition on the surface of the colonic mesentery, even after additional colonic mesentery resection in the same region as previously observed. This zone was used as the cut-off line. There were no complications, such as anastomotic leakage, after the surgery. Conclusion Although accumulation of similar cases is necessary, TG has the potential for use as an auxiliary diagnostic tool in clinical practice. TG can depict the presence or absence of blood flow based on surface temperature without the use of imaging agents, and is inexpensive and easy to perform.
format Article
id doaj-art-91c2e481f98e4b419ae5b26fa4cf0ad2
institution Kabale University
issn 2198-7793
language English
publishDate 2023-09-01
publisher Japan Surgical Society
record_format Article
series Surgical Case Reports
spelling doaj-art-91c2e481f98e4b419ae5b26fa4cf0ad22025-08-20T03:36:58ZengJapan Surgical SocietySurgical Case Reports2198-77932023-09-01911510.1186/s40792-023-01752-2A case of laparoscopic sigmoidectomy using thermography for colonic blood flow assessmentTomohiro Kako0Masahiro Kimura1Ryo Nomura2Shuhei Uehara3Hiroshi Uematsu4Seiichi Nakaya5Yuzo Maeda6Ken Tsuboi7Koshiro Harata8Shuji Takiguchi9Department of Gastroenterological Surgery, Nagoya City University East Medical CenterDepartment of Gastroenterological Surgery, Nagoya City University East Medical CenterDepartment of Gastroenterological Surgery, Nagoya City University East Medical CenterDepartment of Gastroenterological Surgery, Nagoya City University HospitalDepartment of Gastroenterological Surgery, Nagoya City University East Medical CenterDepartment of Gastroenterological Surgery, Nagoya City University Midori Municipal HospitalDepartment of Gastroenterological Surgery, Nagoya City University East Medical CenterDepartment of Gastroenterological Surgery, Nagoya City University East Medical CenterDepartment of Gastroenterological Surgery, Nagoya City University East Medical CenterDepartment of Gastroenterological Surgery, Nagoya City University HospitalAbstract Background Indocyanine green (ICG) fluorescence imaging is widely used in gastrointestinal surgery and is considered useful for reducing anastomotic leakage; however, because ICG remains in the tissue for a certain amount of time, we occasionally must re-evaluate colonic blood flow over a short time period during surgery. Herein, we verify the usefulness of thermography (TG) for evaluating colonic blood flow in a patient who underwent a laparoscopic sigmoidectomy for sigmoid colon cancer. Case presentation The patient is 43-year-old man who underwent laparoscopic resection of the sigmoid colon for colon cancer. After vascular treatment of the colonic mesentery, ICG/TG identified the boundary between ischemic and non-ischemic colon tissues. An additional 2 cm of colonic mesentery was resected because of the presence of a diverticulum noted at the intended site of oral anastomosis when attaching the anvil head. After additional vascular treatment of the colonic mesentery and administration of ICG, fluorescence was observed in the colon; however, TG identified the zone of the temperature transition on the surface of the colonic mesentery, even after additional colonic mesentery resection in the same region as previously observed. This zone was used as the cut-off line. There were no complications, such as anastomotic leakage, after the surgery. Conclusion Although accumulation of similar cases is necessary, TG has the potential for use as an auxiliary diagnostic tool in clinical practice. TG can depict the presence or absence of blood flow based on surface temperature without the use of imaging agents, and is inexpensive and easy to perform.https://doi.org/10.1186/s40792-023-01752-2ThermographyIndocyanine greenColonic blood flow
spellingShingle Tomohiro Kako
Masahiro Kimura
Ryo Nomura
Shuhei Uehara
Hiroshi Uematsu
Seiichi Nakaya
Yuzo Maeda
Ken Tsuboi
Koshiro Harata
Shuji Takiguchi
A case of laparoscopic sigmoidectomy using thermography for colonic blood flow assessment
Surgical Case Reports
Thermography
Indocyanine green
Colonic blood flow
title A case of laparoscopic sigmoidectomy using thermography for colonic blood flow assessment
title_full A case of laparoscopic sigmoidectomy using thermography for colonic blood flow assessment
title_fullStr A case of laparoscopic sigmoidectomy using thermography for colonic blood flow assessment
title_full_unstemmed A case of laparoscopic sigmoidectomy using thermography for colonic blood flow assessment
title_short A case of laparoscopic sigmoidectomy using thermography for colonic blood flow assessment
title_sort case of laparoscopic sigmoidectomy using thermography for colonic blood flow assessment
topic Thermography
Indocyanine green
Colonic blood flow
url https://doi.org/10.1186/s40792-023-01752-2
work_keys_str_mv AT tomohirokako acaseoflaparoscopicsigmoidectomyusingthermographyforcolonicbloodflowassessment
AT masahirokimura acaseoflaparoscopicsigmoidectomyusingthermographyforcolonicbloodflowassessment
AT ryonomura acaseoflaparoscopicsigmoidectomyusingthermographyforcolonicbloodflowassessment
AT shuheiuehara acaseoflaparoscopicsigmoidectomyusingthermographyforcolonicbloodflowassessment
AT hiroshiuematsu acaseoflaparoscopicsigmoidectomyusingthermographyforcolonicbloodflowassessment
AT seiichinakaya acaseoflaparoscopicsigmoidectomyusingthermographyforcolonicbloodflowassessment
AT yuzomaeda acaseoflaparoscopicsigmoidectomyusingthermographyforcolonicbloodflowassessment
AT kentsuboi acaseoflaparoscopicsigmoidectomyusingthermographyforcolonicbloodflowassessment
AT koshiroharata acaseoflaparoscopicsigmoidectomyusingthermographyforcolonicbloodflowassessment
AT shujitakiguchi acaseoflaparoscopicsigmoidectomyusingthermographyforcolonicbloodflowassessment
AT tomohirokako caseoflaparoscopicsigmoidectomyusingthermographyforcolonicbloodflowassessment
AT masahirokimura caseoflaparoscopicsigmoidectomyusingthermographyforcolonicbloodflowassessment
AT ryonomura caseoflaparoscopicsigmoidectomyusingthermographyforcolonicbloodflowassessment
AT shuheiuehara caseoflaparoscopicsigmoidectomyusingthermographyforcolonicbloodflowassessment
AT hiroshiuematsu caseoflaparoscopicsigmoidectomyusingthermographyforcolonicbloodflowassessment
AT seiichinakaya caseoflaparoscopicsigmoidectomyusingthermographyforcolonicbloodflowassessment
AT yuzomaeda caseoflaparoscopicsigmoidectomyusingthermographyforcolonicbloodflowassessment
AT kentsuboi caseoflaparoscopicsigmoidectomyusingthermographyforcolonicbloodflowassessment
AT koshiroharata caseoflaparoscopicsigmoidectomyusingthermographyforcolonicbloodflowassessment
AT shujitakiguchi caseoflaparoscopicsigmoidectomyusingthermographyforcolonicbloodflowassessment