ArticleSurgical endoscopy2023
Robot-assisted fluorescent sentinel lymph node identification in early-stage colon cancer.
Article in Surgical endoscopy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.
- Fluorescence indocyanine green (ICG) for sentinel-lymph-node mapping in colorectal cancer: a systematic review.Langenbeck's archives of surgery · 2025Pooled it
- Using contrast-enhancing software to improve sentinel lymph node detection with indocyanine green in colon cancer surgery.Techniques in coloproctology · 2026Article
- Fluorescence-Guided Surgery in Colorectal Cancer: State-of-the-Art and Translational Perspectives.Current oncology (Toronto, Ont.) · 2026Review
- Fluorescence-guided surgery in colorectal cancer: current evidence, quantitative advances, and future perspectives.Annals of coloproctology · 2026Review
- Exploring Vitamin E's Role in Colorectal Cancer Growth Using Rodent Models: A Scoping Review.Nutrients · 2026Review
- Review
- Factors associated with lymph node metastasis and survival in T2 colon cancer.BMC gastroenterology · 2025Article
- Enhanced Lymph Node Detection in Colon Cancer Using Indocyanine Green Fluorescence: A Systematic Review of Studies from 2020 Onwards.Journal of personalized medicine · 2025Review
- Article
- Review
- The potential of indocyanine green fluorescence detection in surgical cut margin of breast conserving surgery.Gland surgery · 2024Article
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPatients with cT1-2 colon cancer (CC) have a 10-20% risk of lymph node metastases. Sentinel lymph node identification (SLNi) could improve staging and reduce morbidity in future organ-preserving CC surgery. This pilot study aimed to assess safety and feasibility of robot-assisted fluorescence-guided SLNi using submucosally injected indocyanine green (ICG) in patients with cT1-2N0M0 CC.
methodsTen consecutive patients with cT1-2N0M0 CC were included in this prospective feasibility study. Intraoperative submucosal, peritumoral injection of ICG was performed during a colonoscopy. Subsequently, the near-infrared fluorescence 'Firefly' mode of the da Vinci Xi robotic surgical system was used for SLNi. SLNs were marked with a suture, after which a segmental colectomy was performed. The SLN was postoperatively ultrastaged using serial slicing and immunohistochemistry, in addition to the standard pathological examination of the specimen. Colonoscopy time, detection time (time from ICG injection to first SLNi), and total SLNi time were measured (time from the start of colonoscopy to start of segmental resection). Intraoperative, postoperative, and pathological outcomes were registered.
resultsIn all patients, at least one SLN was identified (mean 2.3 SLNs, SLN diameter range 1-13 mm). No tracer-related adverse events were noted. Median colonoscopy time was 12 min, detection time was 6 min, and total SLNi time was 30.5 min. Two patients had lymph node metastases present in the SLN, and there were no patients with false negative SLNs. No patient was upstaged due to ultrastaging of the SLN after an initial negative standard pathological examination. Half of the patients unexpectedly had pT3 tumours.
conclusionsRobot-assisted fluorescence-guided SLNi using submucosally injected ICG in ten patients with cT1-2N0M0 CC was safe and feasible. SLNi was performed in an acceptable timespan and SLNs down to 1 mm were detected. All lymph node metastases would have been detected if SLN biopsy had been performed.
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