Image: Tissue before and after injection with a NIR fluorescent dye (Photo courtesy of NYU Langone Medical Center).
A near-infrared (NIR) fluorescence imaging aid presents a greatly enhanced visual field, allowing finer assessment and more precise operations with the da Vinci Si surgical system.
The new technique incorporates a redesigned three-dimensional (3D) high definition (HD) camera that is mounted on one of the four arms of the da Vinci Si surgical robot, a product of Intuitive Surgical (Sunnyvale, CA, USA). In addition to standard real-time images of the surgical field, the camera can switch to view captured images of tissue and surrounding blood vessels by injecting a unique fluorescence dye that is activated by NIR light, which spans the range from approximately 700 nm to 2,500 nm. The technique further advances the benefits of robotic surgery, resulting in better patient outcomes, minimal scarring, and faster recovery times for patients.
"Florescence imaging combined with the new 3D HD camera scopes gives us clear anatomical landmarks to better map the patient's vascular anatomy - it's changing the way we perform surgery,” said Michael Stifelman, MD, director of the robotic surgery center at the New York University (NYU) Langone Medical Center (NY, USA). "We can now perform complex kidney surgery in a more sparing manner using a minimally invasive approach. The imagery is so precise we can temporarily stop blood flow to only the part of the kidney needing dissection, allowing the rest of the kidney to remain perfused, which prevents potential damage to the healthy tissue.”
The da Vinci system consists of a surgeon's console that is typically in the same room as the patient and a patient-side cart with four interactive robotic arms controlled from the console. Three of the arms are for tools that can hold objects, act as a scalpel, scissors, bovie, or unipolar or dipolar electrocautery instruments. The fourth arm is for an endoscopic camera with two lenses that gives the surgeon full stereoscopic vision from the console. The surgeon sits at the console watching a 3D image of the procedure, while maneuvering the robotic arms with two foot pedals and two hand controllers. The da Vinci System scales, filters, and translates the surgeon's hand movements into more precise micromovements of the instruments, which operate through small incisions in the body.
New York University (NYU) Langone Medical Center