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.