NYU Langone Medical Center launched a new era in March after completing its first surgery using a new near-infrared fluorescence imaging guided system available on the da Vinci Si Surgical System (Intuitive Surgical). The system is in use in just a few sites around the world, and NYU Langone says is the first to put it to use for selective arterial clamping during kidney sparing surgery for patients with kidney cancer.
The technique incorporates a redesigned 3-D HD camera that is mounted on one of the four arms of the da Vinci system. Doctors inject the patient with a fluorescence dye that is activated by near-infrared light. Then, because the camera can switch from standard real-time imaging of the surgical field, the medical team can get an additional view of images of tissue and surrounding blood vessels.
The result is a greatly enhanced visual field, allowing finer assessment and more precise operations: ”Fluorescence imaging combined with the new 3-D HD camera scopes gives us clear anatomical landmarks to better map the patient’s vascular anatomy—it’s changing the way we perform surgery,” said Michael Stifelman, associate professor, Department of Urology and director of NYU Langone’s Robotic Surgery Center. “We can now perform complex kidney surgery in a more sparing manner using a minimally invasive approach. The imagery is so precise we can temporarily stop blood flow to only the part of the kidney needing dissection, allowing the rest of the kidney to remain perfused, which prevents potential damage to the healthy tissue.”