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Innovative marking method using novel endoscopic clip equipped with fluorescent resin to locate gastric cancer
Author(s) -
Namikawa Tsutomu,
Hashiba Motoi,
Kitagawa Hiroyuki,
Mizuta Hiroshi,
Uchida Kazushige,
Sato Takayuki,
Kobayashi Michiya,
Hanazaki Kazuhiro
Publication year - 2021
Publication title -
asian journal of endoscopic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.372
H-Index - 18
eISSN - 1758-5910
pISSN - 1758-5902
DOI - 10.1111/ases.12842
Subject(s) - medicine , clips , indocyanine green , resection margin , esophagogastroduodenoscopy , radiology , gastrectomy , cancer , surgery , stomach , endoscope , surgical margin , laparoscopic surgery , endoscopy , laparoscopy , resection
An asymptomatic 76‐year‐old man presented to our department for the treatment of gastric cancer. Esophagogastroduodenoscopy revealed a superficial elevated lesion with an irregular central depression in the lower third of the stomach; this was confirmed to be adenocarcinoma by biopsy, while abdominal contrast‐enhanced CT revealed no abnormal lesions. Based on the patient's clinical diagnosis of early gastric cancer, we planned laparoscopic gastrectomy with preoperative placement of four endoscopic marking clips equipped with indocyanine green‐conjugated resin to determine the resection margin. During surgery, a dedicated laparoscopic system was used to detect indocyanine green fluorescence emitted by the clips and determine their precise position. The clips helped to identify an accurate resection line for the stomach, enabling accurate laparoscopic distal gastrectomy with regional lymphadenectomy. We successfully demonstrated the usefulness of clips with fluorescent resin for detecting gastric cancer in patients. We report the first case using the clips to accurately locate a site of interest.