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Kamada T, Ohdaira H, Nakashima K, Nishide R, Nishie R, Takahashi J, Ito E, Nakaseko Y, Suzuki N, Yoshida M, Sumi M, Suzuki Y. Real-time vessel navigation using indocyanine green fluorescence during robotic-assisted gastrectomy for gastric cancer after coronary artery bypass grafting using the right gastroepiploic artery. Asian J Endosc Surg 2023. [PMID: 36599190 DOI: 10.1111/ases.13161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/21/2022] [Accepted: 12/25/2022] [Indexed: 01/05/2023]
Abstract
Injury to the right gastroepiploic artery (RGEA) graft during gastrectomy after coronary artery bypass grafting (CABG) can cause critical coronary failure. A man in his 60s with advanced gastric cancer and a history of CABG was admitted to our hospital. His cardiac blood flow was dependent on RGEA, and a gastrectomy with RGEA preservation was necessary. Robot-assisted distal gastrectomy with real-time vessel navigation using indocyanine green (ICG) fluorescence imaging and Da Vinci Firefly technology was planned. Intraperitoneal observation revealed severe adhesions around the graft. Two milliliters ICG (2.5 mg/mL) was injected intravenously, and RGEA was visualized. An RGEA-preserving robot-assisted distal gastrectomy was successfully performed. The operation time was 279 minutes, and the blood loss was 5 mL. The postoperative course was good and there were no complications.
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Affiliation(s)
- Teppei Kamada
- Department of Surgery, International University of Health and Welfare Hospital, Nasushiobara, Japan
| | - Hironori Ohdaira
- Department of Surgery, International University of Health and Welfare Hospital, Nasushiobara, Japan
| | - Keigo Nakashima
- Department of Surgery, International University of Health and Welfare Hospital, Nasushiobara, Japan
| | - Ryo Nishide
- Department of Surgery, International University of Health and Welfare Hospital, Nasushiobara, Japan
| | - Ryosuke Nishie
- Department of Vascular Surgery, International University of Health and Welfare Hospital, Nasushiobara, Japan
| | - Junji Takahashi
- Department of Surgery, International University of Health and Welfare Hospital, Nasushiobara, Japan
| | - Eisaku Ito
- Department of Surgery, International University of Health and Welfare Hospital, Nasushiobara, Japan
| | - Yuichi Nakaseko
- Department of Surgery, International University of Health and Welfare Hospital, Nasushiobara, Japan
| | - Norihiko Suzuki
- Department of Surgery, International University of Health and Welfare Hospital, Nasushiobara, Japan
| | - Masahi Yoshida
- Department of Surgery, International University of Health and Welfare Hospital, Nasushiobara, Japan
| | - Makoto Sumi
- Department of Vascular Surgery, International University of Health and Welfare Hospital, Nasushiobara, Japan
| | - Yutaka Suzuki
- Department of Surgery, International University of Health and Welfare Hospital, Nasushiobara, Japan
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