The Experts below are selected from a list of 411 Experts worldwide ranked by ideXlab platform
Hiroyasu Yokomise - One of the best experts on this subject based on the ideXlab platform.
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clinical trial of new methods for identifying lung intersegmental borders using infrared thoracoscopy with indocyanine green comparative analysis of 2 and 1 wavelength methods
2013Co-Authors: Yoshitaka Kasai, Shintaro Tarumi, Sung Soo Chang, Noriyuki Misaki, Masashi Gotoh, Tetsuhiko Go, Hiroyasu YokomiseAbstract:OBJECTIVES: Infrared thoracoscopy is a new method of identifying lung intersegmental borders. This study compared the efficacy of 2- and 1-wavelength infrared thoracoscopy. METHODS: A total of 30 consecutive patients who underwent segmentectomy were evaluated by these methods (2-wavelength method, 10 patients; 1-wavelength method, 20 patients). We ligated the dominant pulmonary artery and then observed the lung using an infrared Thoracoscope after indocyanine green (ICG) intravenous injection. The 2-wavelength infrared Thoracoscope irradiation and detection were conducted at 940 and 805 nm, respectively, and the images were projected based on the difference of the two reflected wavelengths. ICG absorbs 805 nm wavelength light, and the ICG distribution area appears blue against a white background. On the other hand, the 1-wavelength infrared Thoracoscope irradiation and detection were conducted at 780 and 830 nm, respectively. The area stained with ICG shows fluorescence. RESULTS: In the 2-wavelength method, 3.0 mg/kg of ICG was administered, and a well-defined white-to-blue border was observed in 9 of 10 patients. The staining duration was 220 (interquartile range, 187–251) s. In the 1-wavelength method, 0.5 mg/kg of ICG was administered, and a well-defined border between areas with or without fluorescence was observed in 19 of 20 patients. The staining duration was 370 (interquartile range, 296–440) s, which was significantly longer than the staining duration with the 2-wavelength method (P= 0.0001). CONCLUSIONS: Infrared thoracoscopy is useful for detection of intersegmental borders. The dose of ICG for the 1-wavelength method was less than that for 2-wavelength method, and the duration of staining was longer.
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new clinically applicable method for visualizing adjacent lung segments using an infrared thoracoscopy system
2010Co-Authors: Noriyuki Misaki, Sung Soo Chang, Masashi Gotoh, Hitoshi Igai, Shintarou Tarumi, Hiroyasu YokomiseAbstract:Objective Our objective was to attempt a clinical trial of segmentectomy using the infrared thoracoscopy system after intravenous injection of indocyanine green. Patients and Methods A total of 8 patients with lung lesions were investigated (5 with primary lung cancer, 2 with metastatic lung tumor, and 1 with inflammatory change). All were scheduled to undergo segmentectomy and had been confirmed to have no allergy to iodine or indocyanine green. Informed consent was obtained from all patients. We identified the dominant pulmonary artery supplying the target segment using reconstructed computed tomography images. The dominant pulmonary artery of the target segment was ligated, and after we had observed the lung using the infrared thoracoscopy system after intravenous injection of indocyanine green (3.0 mg/kg), and marked the white-to-blue transitional zone by electrocautery, we performed segmentectomy. Results Average operation time was 150 ± 62.1 minutes, and bleeding volume was 68.8 ± 30.5 mL. Under infrared thoracoscopy, the area with a normal blood supply became stained blue 13 seconds after injection of indocyanine green. Maximum staining intensity was attained 28 seconds after dye injection, and the observation duration was 3.5 minutes. A well-defined color zonation was observed in all patients. We had enough time to mark it. No complications attributable to infrared thoracoscopy after intravenous injection of indocyanine green were encountered. Conclusions Infrared thoracoscopy with indocyanine green makes it possible to identify the target lung segment easily and quickly without the need for inflation. This method will be especially useful for cases associated with severe emphysema or when surgery offers a limited view, as is the case with video-assisted thoracic surgery.
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a novel method for determining adjacent lung segments with infrared thoracoscopy
2009Co-Authors: Noriyuki Misaki, Sung Soo Chang, Masashi Gotoh, Yasumichi Yamamoto, K Satoh, Hiroyasu YokomiseAbstract:Objectives We investigated a new technique for identifying the lung intersegmental line using infrared thoracoscopy with intravenous injection of indocyanine green. Methods This was an experimental animal study, and target segments were established preoperatively. Six adult beagle dogs underwent thoracotomy. After the corresponding pulmonary artery of the target segment had been ligated, indocyanine green was administered intravenously during infrared thoracoscopy. The lung was separated into 2 areas, white and blue, according to the blood flow on the monitor. We marked the visceral pleura with electrocautery along the transition zone showing a change in color from blue to white. The experimental lung was removed and subjected to pathologic and radiologic analysis. Results After injection of indocyanine green, infrared thoracoscopy showed that the area of normal perfusion changed to blue, whereas the area at which perfusion was absent remained white. The transition zone between colors was distinct, and the blue stain remained visible during the marking procedure. Three-dimensional computed tomographic analysis indicated that the marking separated the target segmental bronchus from the adjacent one. Detailed macroscopic and microscopic study confirmed that the marking corresponded to the intersegmental line. Conclusion By using infrared thoracoscopy with indocyanine green, it is possible to detect the intersegmental line without inflating the lung.
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clinical application of infrared thoracoscopy to detect bullous or emphysematous lesions of the lung
2007Co-Authors: Masashi Gotoh, Sung Soo Chang, Yasumichi Yamamoto, Chenglong Huang, Hitoshi Igai, Hiroyasu YokomiseAbstract:Objective We have previously reported that infrared thoracoscopy was useful in detecting emphysematous lesions in a canine model of lung emphysema. We applied infrared thoracoscopy to determine the feasibility and efficacy of planning bullectomy for patients with spontaneous pneumothorax. Methods A total of 8 patients with spontaneous pneumothorax were included in the study. No procedure-related complications were observed. Infrared thoracoscopy with a single injection of indocyanine green (3.0 mg/kg) was used to detect bullous lesions of the lung during surgical intervention. Partial lung resections of the bullous lesions were performed after image analysis based on color density data obtained by means of infrared thoracoscopy. Results Bullous or emphysematous lesions of the lung were demonstrated in white, whereas normal lung tissue was imaged in blue, under infrared thoracoscopy. We were able to detect small bullous lesions with infrared thoracoscopy because of its clearer visualization compared with thoracoscopy. Quantitative color-density analysis revealed a marked decrease of indocyanine green intensity, which reflected decreased blood flow of bullous lesions. All resected specimens were confirmed as bullous lesions based on microscopic examinations. Conclusion Infrared thoracoscopy–guided lung resection is a safe and useful procedure in detecting small bullous lesions.
Gang Hou - One of the best experts on this subject based on the ideXlab platform.
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semi rigid thoracoscopic punch biopsy using a hybrid knife with a high pressure water jet for the diagnosis of pleural effusions
2016Co-Authors: Yan Yin, Xiao-bo Wang, Ralf Eberhardt, Felix J.f. Herth, Jian Kang, Qiuyue Wang, Gang HouAbstract:Semi-rigid thoracoscopy is an important technique in the definitive diagnosis of pleural diseases with high diagnostic sensitivity and specificity. Obtaining adequate samples from thickened pleura is the most important limitation of semi-rigid thoracoscopy with a standard flexible forceps (SFF) compared with rigid thoracoscopy, especially in patients with mesothelioma or benign fibrothorax. Developing a convenient, efficient and safe biopsy technique to obtain sufficient samples from such patients is a key topic in semi-rigid thoracoscopy. The hybrid knife (HK) is an innovative design fusing high-pressure water injection and a conventional diathermic knife that can allow for the safe resection of a larger lesion during gastrointestinal endoscopic dissection. Here, we describe 3 patients with unexplained pleural effusion who underwent pleural biopsy using an HK to investigate the potential use of the HK as a new pleural biopsy device in semi-rigid thoracoscopy when pleural lesions are difficult to biopsy using an SFF. The biopsies were obtained successfully by HK, and the diagnosis followed. The sizes of the biopsies collected by HK are larger than those collected by SFF. No complications were observed. Electrocautery biopsy using an HK during semi-rigid thoracoscopy has great potential for diagnosing consistent abnormal pleuras, which are difficult to biopsy with an SFF.
Masashi Gotoh - One of the best experts on this subject based on the ideXlab platform.
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clinical trial of new methods for identifying lung intersegmental borders using infrared thoracoscopy with indocyanine green comparative analysis of 2 and 1 wavelength methods
2013Co-Authors: Yoshitaka Kasai, Shintaro Tarumi, Sung Soo Chang, Noriyuki Misaki, Masashi Gotoh, Tetsuhiko Go, Hiroyasu YokomiseAbstract:OBJECTIVES: Infrared thoracoscopy is a new method of identifying lung intersegmental borders. This study compared the efficacy of 2- and 1-wavelength infrared thoracoscopy. METHODS: A total of 30 consecutive patients who underwent segmentectomy were evaluated by these methods (2-wavelength method, 10 patients; 1-wavelength method, 20 patients). We ligated the dominant pulmonary artery and then observed the lung using an infrared Thoracoscope after indocyanine green (ICG) intravenous injection. The 2-wavelength infrared Thoracoscope irradiation and detection were conducted at 940 and 805 nm, respectively, and the images were projected based on the difference of the two reflected wavelengths. ICG absorbs 805 nm wavelength light, and the ICG distribution area appears blue against a white background. On the other hand, the 1-wavelength infrared Thoracoscope irradiation and detection were conducted at 780 and 830 nm, respectively. The area stained with ICG shows fluorescence. RESULTS: In the 2-wavelength method, 3.0 mg/kg of ICG was administered, and a well-defined white-to-blue border was observed in 9 of 10 patients. The staining duration was 220 (interquartile range, 187–251) s. In the 1-wavelength method, 0.5 mg/kg of ICG was administered, and a well-defined border between areas with or without fluorescence was observed in 19 of 20 patients. The staining duration was 370 (interquartile range, 296–440) s, which was significantly longer than the staining duration with the 2-wavelength method (P= 0.0001). CONCLUSIONS: Infrared thoracoscopy is useful for detection of intersegmental borders. The dose of ICG for the 1-wavelength method was less than that for 2-wavelength method, and the duration of staining was longer.
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new clinically applicable method for visualizing adjacent lung segments using an infrared thoracoscopy system
2010Co-Authors: Noriyuki Misaki, Sung Soo Chang, Masashi Gotoh, Hitoshi Igai, Shintarou Tarumi, Hiroyasu YokomiseAbstract:Objective Our objective was to attempt a clinical trial of segmentectomy using the infrared thoracoscopy system after intravenous injection of indocyanine green. Patients and Methods A total of 8 patients with lung lesions were investigated (5 with primary lung cancer, 2 with metastatic lung tumor, and 1 with inflammatory change). All were scheduled to undergo segmentectomy and had been confirmed to have no allergy to iodine or indocyanine green. Informed consent was obtained from all patients. We identified the dominant pulmonary artery supplying the target segment using reconstructed computed tomography images. The dominant pulmonary artery of the target segment was ligated, and after we had observed the lung using the infrared thoracoscopy system after intravenous injection of indocyanine green (3.0 mg/kg), and marked the white-to-blue transitional zone by electrocautery, we performed segmentectomy. Results Average operation time was 150 ± 62.1 minutes, and bleeding volume was 68.8 ± 30.5 mL. Under infrared thoracoscopy, the area with a normal blood supply became stained blue 13 seconds after injection of indocyanine green. Maximum staining intensity was attained 28 seconds after dye injection, and the observation duration was 3.5 minutes. A well-defined color zonation was observed in all patients. We had enough time to mark it. No complications attributable to infrared thoracoscopy after intravenous injection of indocyanine green were encountered. Conclusions Infrared thoracoscopy with indocyanine green makes it possible to identify the target lung segment easily and quickly without the need for inflation. This method will be especially useful for cases associated with severe emphysema or when surgery offers a limited view, as is the case with video-assisted thoracic surgery.
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a novel method for determining adjacent lung segments with infrared thoracoscopy
2009Co-Authors: Noriyuki Misaki, Sung Soo Chang, Masashi Gotoh, Yasumichi Yamamoto, K Satoh, Hiroyasu YokomiseAbstract:Objectives We investigated a new technique for identifying the lung intersegmental line using infrared thoracoscopy with intravenous injection of indocyanine green. Methods This was an experimental animal study, and target segments were established preoperatively. Six adult beagle dogs underwent thoracotomy. After the corresponding pulmonary artery of the target segment had been ligated, indocyanine green was administered intravenously during infrared thoracoscopy. The lung was separated into 2 areas, white and blue, according to the blood flow on the monitor. We marked the visceral pleura with electrocautery along the transition zone showing a change in color from blue to white. The experimental lung was removed and subjected to pathologic and radiologic analysis. Results After injection of indocyanine green, infrared thoracoscopy showed that the area of normal perfusion changed to blue, whereas the area at which perfusion was absent remained white. The transition zone between colors was distinct, and the blue stain remained visible during the marking procedure. Three-dimensional computed tomographic analysis indicated that the marking separated the target segmental bronchus from the adjacent one. Detailed macroscopic and microscopic study confirmed that the marking corresponded to the intersegmental line. Conclusion By using infrared thoracoscopy with indocyanine green, it is possible to detect the intersegmental line without inflating the lung.
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clinical application of infrared thoracoscopy to detect bullous or emphysematous lesions of the lung
2007Co-Authors: Masashi Gotoh, Sung Soo Chang, Yasumichi Yamamoto, Chenglong Huang, Hitoshi Igai, Hiroyasu YokomiseAbstract:Objective We have previously reported that infrared thoracoscopy was useful in detecting emphysematous lesions in a canine model of lung emphysema. We applied infrared thoracoscopy to determine the feasibility and efficacy of planning bullectomy for patients with spontaneous pneumothorax. Methods A total of 8 patients with spontaneous pneumothorax were included in the study. No procedure-related complications were observed. Infrared thoracoscopy with a single injection of indocyanine green (3.0 mg/kg) was used to detect bullous lesions of the lung during surgical intervention. Partial lung resections of the bullous lesions were performed after image analysis based on color density data obtained by means of infrared thoracoscopy. Results Bullous or emphysematous lesions of the lung were demonstrated in white, whereas normal lung tissue was imaged in blue, under infrared thoracoscopy. We were able to detect small bullous lesions with infrared thoracoscopy because of its clearer visualization compared with thoracoscopy. Quantitative color-density analysis revealed a marked decrease of indocyanine green intensity, which reflected decreased blood flow of bullous lesions. All resected specimens were confirmed as bullous lesions based on microscopic examinations. Conclusion Infrared thoracoscopy–guided lung resection is a safe and useful procedure in detecting small bullous lesions.
Izidor Kern - One of the best experts on this subject based on the ideXlab platform.
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feasibility and safety of parietal pleural cryobiopsy during semi rigid thoracoscopy
2016Co-Authors: Ales Rozman, Luka Camlek, Mateja Marc Malovrh, Izidor Kern, Nicolas SchonfeldAbstract:Background and Aims Performing pleural biopsies during semi-rigid thoracoscopy is sometimes a difficult and time-consuming task because of the lack of mechanical power of dedicated flexible forceps in patients with thickened pleura. The purpose of this first ever pilot study was to test the feasibility of taking biopsy specimens by cryoprobe from the parietal pleura during semi-rigid thoracoscopy. Our aim was also to assess the diagnostic value and quality of specimens obtained, morphological features, feasibility of immunohistochemistry staining and possibility of DNA isolation. The secondary aim was to evaluate safety, tolerability and duration of the procedure. Methods Fifteen patients with pleural effusion of unknown origin that underwent semi-rigid thoracoscopy were included. Biopsies were obtained using a flexible autoclavable cryoprobe 20416-032 (Erbokryo CA, ERBE, Tubingen, Germany) 2.4 mm in diameter and a semi-rigid autoclavable Olympus LTF-160 (Olympus, Tokyo, Japan) Thoracoscope. Results Tissue samples were obtained from 14 patients (93.3%), three from each. Of the samples, 81% were easily interpretable and 19% were interpretable with some difficulty by the pathologist. The samples were of good quality, with the level of artifacts below 25%. The specimens were adequate for histological diagnosis, immunohistochemical staining and DNA isolation. There were no moderate or major bleeding problems after the biopsies; two patients experienced pain. The median duration of three cryobiopsies (per patient) was 4 min (range 3–6 min). Conclusions Cryobiopsy during semi-rigid thoracoscopy appears worth to be evaluated in a larger prospective multicenter trial as our preliminary data were promising for efficacy and safety.
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rigid versus semi rigid thoracoscopy for the diagnosis of pleural disease a randomized pilot study
2013Co-Authors: Ales Rozman, Luka Camlek, Mateja Marcmalovrh, Nadja Triller, Izidor KernAbstract:Background and objective Thoracoscopy with a semi-rigid instrument is a recent technique successfully used for diagnosing pleural diseases. However, there are concerns about the diagnostic adequacy of biopsy samples obtained by semi-rigid procedures when compared with rigid thoracoscopy. The purpose of this study was to compare the size, quality and diagnostic adequacy of biopsy specimens obtained at semi-rigid and rigid thoracoscopy in a prospective, randomized fashion. Methods Patients with pleural effusion of unknown origin and/or pleural irregularities suspicious for pleural malignancy were included after less invasive means of diagnosis had failed. All procedures were performed under local anaesthesia with intravenous sedation/analgesia with a single point of entry. Patients were randomly assigned to a rigid instrument procedure (Olympus EndoEYE WA50120A, forceps) or semi-rigid instrument procedure (Olympus LTF-160, FB-55CR-1 forceps). Results Eighty-four patients were randomized. Five of them were excluded because of lack of pleural space. Thirty-eight patients were assigned to a rigid and 41 to a semi-rigid procedure, with mean follow up 24.1 (±8.1) months after the procedure. The average size of the sample obtained by rigid thoracoscopy was 24.7 mm2 (±12.9), and 11.7 mm2 (±7.6) by semi-rigid thoracoscopy. There were no differences in the quality and interpretability of the specimens assessed by the pathologist. The diagnostic accuracy was 100% for the rigid procedure and 97.6% for the semi-rigid procedure. Conclusions The samples obtained by semi-rigid thoracoscopy were smaller, but of adequate quality. The diagnostic accuracy was comparable with that of rigid thoracoscopy in the evaluation of pleural disease.
Noriyuki Misaki - One of the best experts on this subject based on the ideXlab platform.
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clinical trial of new methods for identifying lung intersegmental borders using infrared thoracoscopy with indocyanine green comparative analysis of 2 and 1 wavelength methods
2013Co-Authors: Yoshitaka Kasai, Shintaro Tarumi, Sung Soo Chang, Noriyuki Misaki, Masashi Gotoh, Tetsuhiko Go, Hiroyasu YokomiseAbstract:OBJECTIVES: Infrared thoracoscopy is a new method of identifying lung intersegmental borders. This study compared the efficacy of 2- and 1-wavelength infrared thoracoscopy. METHODS: A total of 30 consecutive patients who underwent segmentectomy were evaluated by these methods (2-wavelength method, 10 patients; 1-wavelength method, 20 patients). We ligated the dominant pulmonary artery and then observed the lung using an infrared Thoracoscope after indocyanine green (ICG) intravenous injection. The 2-wavelength infrared Thoracoscope irradiation and detection were conducted at 940 and 805 nm, respectively, and the images were projected based on the difference of the two reflected wavelengths. ICG absorbs 805 nm wavelength light, and the ICG distribution area appears blue against a white background. On the other hand, the 1-wavelength infrared Thoracoscope irradiation and detection were conducted at 780 and 830 nm, respectively. The area stained with ICG shows fluorescence. RESULTS: In the 2-wavelength method, 3.0 mg/kg of ICG was administered, and a well-defined white-to-blue border was observed in 9 of 10 patients. The staining duration was 220 (interquartile range, 187–251) s. In the 1-wavelength method, 0.5 mg/kg of ICG was administered, and a well-defined border between areas with or without fluorescence was observed in 19 of 20 patients. The staining duration was 370 (interquartile range, 296–440) s, which was significantly longer than the staining duration with the 2-wavelength method (P= 0.0001). CONCLUSIONS: Infrared thoracoscopy is useful for detection of intersegmental borders. The dose of ICG for the 1-wavelength method was less than that for 2-wavelength method, and the duration of staining was longer.
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new clinically applicable method for visualizing adjacent lung segments using an infrared thoracoscopy system
2010Co-Authors: Noriyuki Misaki, Sung Soo Chang, Masashi Gotoh, Hitoshi Igai, Shintarou Tarumi, Hiroyasu YokomiseAbstract:Objective Our objective was to attempt a clinical trial of segmentectomy using the infrared thoracoscopy system after intravenous injection of indocyanine green. Patients and Methods A total of 8 patients with lung lesions were investigated (5 with primary lung cancer, 2 with metastatic lung tumor, and 1 with inflammatory change). All were scheduled to undergo segmentectomy and had been confirmed to have no allergy to iodine or indocyanine green. Informed consent was obtained from all patients. We identified the dominant pulmonary artery supplying the target segment using reconstructed computed tomography images. The dominant pulmonary artery of the target segment was ligated, and after we had observed the lung using the infrared thoracoscopy system after intravenous injection of indocyanine green (3.0 mg/kg), and marked the white-to-blue transitional zone by electrocautery, we performed segmentectomy. Results Average operation time was 150 ± 62.1 minutes, and bleeding volume was 68.8 ± 30.5 mL. Under infrared thoracoscopy, the area with a normal blood supply became stained blue 13 seconds after injection of indocyanine green. Maximum staining intensity was attained 28 seconds after dye injection, and the observation duration was 3.5 minutes. A well-defined color zonation was observed in all patients. We had enough time to mark it. No complications attributable to infrared thoracoscopy after intravenous injection of indocyanine green were encountered. Conclusions Infrared thoracoscopy with indocyanine green makes it possible to identify the target lung segment easily and quickly without the need for inflation. This method will be especially useful for cases associated with severe emphysema or when surgery offers a limited view, as is the case with video-assisted thoracic surgery.
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a novel method for determining adjacent lung segments with infrared thoracoscopy
2009Co-Authors: Noriyuki Misaki, Sung Soo Chang, Masashi Gotoh, Yasumichi Yamamoto, K Satoh, Hiroyasu YokomiseAbstract:Objectives We investigated a new technique for identifying the lung intersegmental line using infrared thoracoscopy with intravenous injection of indocyanine green. Methods This was an experimental animal study, and target segments were established preoperatively. Six adult beagle dogs underwent thoracotomy. After the corresponding pulmonary artery of the target segment had been ligated, indocyanine green was administered intravenously during infrared thoracoscopy. The lung was separated into 2 areas, white and blue, according to the blood flow on the monitor. We marked the visceral pleura with electrocautery along the transition zone showing a change in color from blue to white. The experimental lung was removed and subjected to pathologic and radiologic analysis. Results After injection of indocyanine green, infrared thoracoscopy showed that the area of normal perfusion changed to blue, whereas the area at which perfusion was absent remained white. The transition zone between colors was distinct, and the blue stain remained visible during the marking procedure. Three-dimensional computed tomographic analysis indicated that the marking separated the target segmental bronchus from the adjacent one. Detailed macroscopic and microscopic study confirmed that the marking corresponded to the intersegmental line. Conclusion By using infrared thoracoscopy with indocyanine green, it is possible to detect the intersegmental line without inflating the lung.