Chapter 6 Animal Ethics Committee of Maastricht University (DEC‐UM, project number 2012‐098). A pig model was chosen because of its similarity with human anatomy. Two female Dutch landrace pigs, weighing 35 kg, were used for the current study. Laparoscopic fluorescence imaging system A commercially available, laparoscopic fluorescence imaging system (Karl Storz GmbH & CO. KG, Tuttlingen, Germany) was used. The system included a plasma light guide and 30‐degree 10‐mm laparoscope applicable for both white light and near‐infrared fluorescence imaging. A foot pedal allows the surgeon to easily switch from conventional imaging to fluorescence imaging, and back. Procedures were digitally recorded. Preparation of near‐infrared fluorophore In these animal experiments, the system, which is primarily developed for indocyanine green (ICG) imaging, was tested for its feasibility for real‐time intraoperative fluorescence delineation of the course of the ureters after intravenous administration of pre‐clinical fluorescent dye CW800‐CA (the carboxylic acid form of the near‐infrared fluorophore IRDyeTM 800CW, LI‐COR, Lincoln, Nebraska). CW800‐CA was diluted in a sterile PBS solution. Surgical technique Premedication comprised of intramuscular injection of azaperone 3 mg/kg, ketamine 10 mg/kg and atropine 0.05 mg/kg. Anesthesia was induced with intravenous administration of thiopental 10‐15 mg/kg, intubated and maintained under anesthesia with isoflurane (depending on effect) and oxygen (20‐40 ml/kg/min). Thereafter laparoscopy was performed. For the first experiment, 5 mg of CW800‐CA was diluted in 20 ml of PBS solution (0.25 mg/ml). Next, 1 ml of solution was injected intravenously7. During the second experiment 5 mg of CW800‐CA was diluted in 5 ml of PBS solution (1 mg/ml). Three ml of solution (3 mg) was then administered intravenously. Summary of experiments is shown in Table 6.1. In both experiments, visualization of the course of the ureters was assessed by conventional laparoscopy and fluorescence laparoscopy. Fluorescence imaging was performed initially ten minutes after dye injection and repeated every 15 minutes. Time until clear visualization of the ureters was observed, up to 120 minutes after administration. 80
proefschrift_Schols_SLV
To see the actual publication please follow the link above