Abstract
Background
Retained foreign bodies (RFOs) have substantial clinical and financial consequences.
In laparoscopic surgery, RFOs can be a cause of needing to convert a minimally invasive
surgery (MIS) procedure to an open operation. A coating for surgical models was developed
to augment localization of needles using fluorescence appropriate for open and minimally
invasive surgeries procedures.
Methods
An epoxy matrix containing both dansyl chloride and indocyanine green was coated as
visible and near infrared labels, respectively. With ultraviolet excitation, dansyl
chloride emits green fluorescence and with NIR excitation, the ICG dye emits radiation
observable with specialized near infrared capable laparoscopes. To evaluate the coatings,
open and laproscopic surgeries were simulated in rabbits. Surgeons blinded to the
type of needles (coated or non-coated) were timed while finding needles in standard
conditions and with the use of the adjunct coatings. Control needles not located within
300 seconds were researched with the corresponding near infrared or ultraviolet light.
Localization time was evaluated for statistical significance, P < .05.
Results
All dual dye coated needles searched utilizing the near infrared camera (n = 26) or ultraviolet light (n = 26) were located within 300 seconds. Conversely, 9 needles in both control settings
(no dye usage) were not located within 300 seconds. Mean time to locate control needles
in open surgery and laparoscopic surgery was statistically 2-3× greater than time
to localization with the use of dye as an adjunct (P = .0027 open, P < .001 laparoscopic).
Conclusion
Incorporation of a dual-dye fluorescent coating on surgical needles improved the efficiency
of locating needles, may minimize the need to convert minimally invasive surgeries
procedures to open, and may decrease the consequences of a missed RFO.
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Article info
Publication history
Published online: January 12, 2018
Accepted:
October 4,
2017
Identification
Copyright
Published by Elsevier Inc.
