Evidence map›Paper›PMID 33512630›Full record

ArticleSurgical endoscopy2022

A visual quantification of tissue distinction in robotic transabdominal lateral adrenalectomy: comparison of indocyanine green and conventional views.

Husnu Aydin, Mustafa Donmez, Bora Kahramangil, Emin Kose, Ozgun Erten, Serkan Akbulut, Mehmet Gokceimam, Eren Berber

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In one paragraph

Article in Surgical endoscopy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Husnu AydinDepartment of Endocrine, Cleveland Clinic, 9500 Euclid Ave/F20, Cleveland, OH, 44195, USA.
Mustafa DonmezDepartment of Endocrine, Cleveland Clinic, 9500 Euclid Ave/F20, Cleveland, OH, 44195, USA.
Bora KahramangilDepartment of Endocrine, Cleveland Clinic, 9500 Euclid Ave/F20, Cleveland, OH, 44195, USA.
Emin KoseDepartment of Endocrine, Cleveland Clinic, 9500 Euclid Ave/F20, Cleveland, OH, 44195, USA.
Ozgun ErtenDepartment of Endocrine, Cleveland Clinic, 9500 Euclid Ave/F20, Cleveland, OH, 44195, USA.
Serkan AkbulutDepartment of Endocrine, Cleveland Clinic, 9500 Euclid Ave/F20, Cleveland, OH, 44195, USA.
Mehmet GokceimamDepartment of Endocrine, Cleveland Clinic, 9500 Euclid Ave/F20, Cleveland, OH, 44195, USA.
Eren BerberDepartment of Endocrine, Cleveland Clinic, 9500 Euclid Ave/F20, Cleveland, OH, 44195, USA. berbere@ccf.org.ORCID 0000-0003-4378-1794

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRecent studies have reported the feasibility of indocyanine green fluorescence imaging of adrenal tumors to guide dissection. Although the adrenal has been reported to concentrate the dye more than surrounding tissues, the amount of tissue distinction and how this compares with conventional vision has not been quantified before. The aim of this study is to quantify this distinction using color analysis.

methodsThis was an institutional review board-approved retrospective study. By excluding adrenal cortical carcinoma, metastasis and pheochromocytoma, video recordings of 50 patients who underwent robotic transabdominal lateral adrenalectomy with indocyanine green (ICG) imaging for adrenocortical tumors between August 2015 and May 2018 were reviewed. Using a color analysis software, the pixel intensity of adrenal tumors versus adjacent retroperitoneal tissues was calculated for conventional red, green and blue, as well as indocyanine green (ICG) scales. Statistical analysis was performed using ANOVA.

resultsA total of 50 patients underwent unilateral robotic transabdominal lateral adrenalectomy. All procedures were completed robotically without a conversion to laparoscopy or open. Morbidity was 4%. Measured pixel intensity of adrenal tumors was higher than adjacent retroperitoneal tissues for all conventional color and ICG modes (p < 0.0001), with the gradient being more pronounced for ICG green versus conventional red, green and blue modes.

conclusionsTo our knowledge this is the first study attempting to encode tissue planes in robotic adrenalectomy. The results show that the visual contrast distinction observed between adrenal and adjacent retroperitoneal tissues can be quantified using pixel intensity. ICG enabled the distinction of tissue planes with a wider gradient compared to conventional RGB view, quantifying its subjective benefits reported in prior studies.

Indexed as

Adrenal Gland NeoplasmsLaparoscopyRobotic Surgical ProceduresAdrenalectomyHumansIndocyanine GreenRetrospective StudiesIndocyanine GreenAdrenal tumorsIndocyanine green fluorescenceRobotic adrenalectomy

Identifiers

PMID33512630

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.