Development of a New Laparoscopic Detection System for Gastric Cancer Using Near-Infrared Light-Emitting Clips with Glass Phosphor

Micromachines (Basel). 2019 Jan 24;10(2):81. doi: 10.3390/mi10020081.

Abstract

Laparoscopic surgery is now a standard treatment for gastric cancer. Currently, the location of the gastric cancer is identified during laparoscopic surgery via the preoperative endoscopic injection of charcoal ink around the primary tumor; however, the wide spread of injected charcoal ink can make it difficult to accurately visualize the specific site of the tumor. To precisely identify the locations of gastric tumors, we developed a fluorescent detection system comprising clips with glass phosphor (Yb3+, Nd3+ doped to Bi₂O₃-B₂O₃-based glasses, size: 2 mm × 1 mm × 3 mm) fixed in the stomach and a laparoscopic fluorescent detection system for clip-derived near-infrared (NIR) light (976 nm). We conducted two ex vivo experiments to evaluate the performance of this fluorescent detection system in an extirpated pig stomach and a freshly resected human stomach and were able to successfully detect NIR fluorescence emitted from the clip in the stomach through the stomach wall by the irradiation of excitation light (λ: 808 nm). These results suggest that the proposed combined NIR light-emitting clip and laparoscopic fluorescent detection system could be very useful in clinical practice for accurately identifying the location of a primary gastric tumor during laparoscopic surgery.

Keywords: fluorescent clip; gastric cancer; laparoscopic surgery; near-infrared fluorescence imaging.