A novel indocyanine green-based fluorescent marker for guiding surgical tumor resection

Surgical tumor resection is a common approach to cancer treatment.India Ink tattoos are widely used to aid tumor resection by localizing and mapping the tumor edge at the surface.However,India Ink tattoos are easily obscured during electrosurgical resection,and fade in intensity over time.In this work,a novel near-infrared(NIR)fluorescent marker is introduced as an alternative.The NIR marker was made by mixing indocyanine green(ICG),biocompatible cyanoacrylate,and acetone.The marking strategy was evaluated in a chronic ex vivo feasibility study using porcine tissues,followed by a chronic in vivo mouse study while compared with India Ink.In both studies,signal-to-noise(SNR)ratios and dimensions of the NIR markers and/or India Ink over the study period were calculated and reported.Electrocautery was performed on the last day of the mouse study after mice were euthanized,and SNR ratios and dimensions were quantified and compared.Biopsy was performed at all injection sites and slides were examined by a pathologist.The proposed NIR marker achieved(i)consistent visibility in the 26-day feasibility study and(ii)improved durability,visibility,and biocompatibility when compared to traditional India Ink over the six-week period in an in vivo mouse model.These effects persist after electrocautery whereas the India Ink markers were obscured.The use of a NIR fluorescent presurgical marking strategy has the potential for intraoperative tracking during long-term treatment protocols.

A study of the potential adverse effects of electrosurgical smoke on medical staff during malignant tumor surgery

Objective The aim of this study was to investigate the potential adverse effects of electrosurgical smoke on medical staff performing malignant tumor surgery.Methods This study was divided into two parts:in vitro and in vivo experiments.The human thyroid cancer cell line,ARO,was cultured and passaged.The tumor cells were burned with an ultrasonic scalpel,and the surgical smoke was absorbed by a transwell membrane.The captured particles were diluted in 3 mL of culture medium,and cell survival was assessed under a microscope.DNA was extracted from the cells for genotyping.BALB/c mice were used to construct thyroid cancer xenograft models.The tumor tissues were dissected on day 14 using an ultrasonic scalpel.The smoke from the electrosurgical procedure was collected on a transwell membrane.The membrane was washed in 2 mL of rinsing solution,and the solution was then injected into the right armpit of 10 mice.After sacrifice,the tumor tissues were removed and stained with hematoxylin and eosin(HE).Results Viable ARO cells could be seen on the first day after culturing cell fragments from surgical smoke,and vigorous cell proliferation could be seen on the 17th day of incubation.The genotype of the cells cultured in the presence of smoke particles was identical to the genotype of the original cells.Tumor growth was observed in four out of 10 mice injected with the smoke particle rinse.HE staining showed a significantly increased number of nuclei in the tumor tissue,which was consistent with the general morphological characteristics of malignant tumors.Conclusion Viable tumor cells were detected in surgical smoke generated by ultrasonic scalpel dissection,and these cells had growth activity.Thus,it is necessary to protect patients and medical staff from electrosurgical smoke.

Plasmakinetic enucleation of prostate versus 160-W laser photoselective vaporization for the treatment of benign prostatic hyperplasia

To evaluate the safety and efficacy of plasmakinetic enucleation of the prostate （PKEP） for the treatment of symptomatic benign prostatic hyperplasia （BPH） compared with 160-W lithium triboride laser photoselective vaporization of the prostate （PVP）. From February 2011 to July 2012, a prospective nonrandomized study was performed. One-hundred one patients underwent PKEP, and 110 underwent PVP. No severe intraoperative complications were recorded, and none of the patients in either group required a blood transfusion. Shorter catheterization time （38.14 ± 23.64 h vs 72.54 ± 28.38 h, P 〈 0.001） and hospitalization （2.32 ± 1.25 days vs 4.07±1.23 days, P 〈 0.001） were recorded in the PVP group. At 12-month postoperatively, the PKEP group had a maintained and statistically improvement in International Prostate Symptom Score （IPSS） （4.07 ±2.07 vs 5.00 ±2.10; P〈 0.001）, quality of life （QoL） （1.08 ± 0.72 vs 1.35 ± 0.72; P= 0.007）, maximal urinary flow rate （Qmax） （24.75±5.87 ml s^-1 vs 22.03 ±5.04 ml s^-1; P 〈 0.001）, postvoid residual urine volume （PVR） （14,29 ± 6,97 ml vs 17.00±6.11 ml; P = 0,001）, and prostate-specific antigen （PSA） value （0.78 ±0.57 ng ml^-1 vs 1.27 ±1.07 ng ml^-1; P 〈 0.001）. Both PKEP and PVP relieve low urinary tract symptoms （LUTS） due to BPH with low complication rates. PKEP can completely remove prostatic adenoma while the total amount of tissue removed by PVP is less than that can be removed by PKER Based on our study of the follow-up, PKEP provides better postoperative outcomes than PVP.

Transurethral prostate vaporization using an oval electrode in 82 cases of benign prostatic hyperplasia

OBJECTIVE: To present our initial experience in transurethral vaporization of the prostate (TVP) using an oval electrode for the treatment of benign prostatic hyperplasia (BPH). METHODS: A total of 82 patients underwent TVP procedures with the oval electrode. The newly designed oval-shaped electrode can work with a High Frequency Electrosurgery Unit. Prostate gland tissue was vaporized through an Fr 24 percutaneous nephroscope transurethrally. The operation procedure was similar to transurethral resection of the prostate (TURP) or transurethral laser prostatectomy (TULP). Power setting ranged from 240 W to 320 W. Local vaporization temperature reached 120 degrees C. RESULTS: Urination was recovered in all 82 patients after TVP. Mean post-treatment International Prostate Symptom Score (I-PSS) reduced from 27.10 to 5.05; mean bladder residual urine volume dropped from 147.71 ml to 33.2 ml; and mean urine flow rate (MFR) increased from 4.45 ml/s to 14.57 ml/s (P