Intracorporeal lymph node mapping in colon cancer surgery

Abstract

Introduction: The best approach to lymphadenectomy in colon cancer is still unknown. The debate has centred around different options of standardised "one size fits all" lymph node harvest techniques. A different approach is tailoring lymph node harvest to the patient's lymphatic drainage pattern.

Methods: A technique for individualised lymph node mapping is proposed, which can guide the surgeon intraoperatively. It consists in the intracorporeal injection of 10 mg of indocyanine green at 4 points in the periphery of the colonic tumour. A near infrared camera is used to assess the fluorescence after specimen mobilisation but before extraction, allowing lymphadenectomy based on the patient's own lymphatic drainage.

Results: a video demonstration of the technique and preliminary results in 6 patients is presented in this short report.

Conclusion: intracorporeal lymph node mapping is feasible and safe. Further studies are required to determine the place of this technique in modern oncologic colon surgery.

Keywords: Colon cancer; Fluorescence; Lymph node; Mapping.