Chapter 6 has successfully been demonstrated using a commercially available laparoscopic fluorescence imaging system. This technique may be most effective when performed routinely during all laparoscopic colectomies. Increased costs are involved in terms of the light source, camera and fluorescent dye. It is, however, anticipated that this technique can be helpful to improve the outcome of laparoscopic colorectal surgery through early recognition of ureters, lowering risk of ureteral injury and reducing time of surgical dissection. As the pigs used in this study were rather thin, human studies will need to determine if the dye will be visible in obese patients and if CW800‐CA dose adjustment is needed to accomplish clear detection of the ureters. A clinical pilot study investigating the feasibility of near‐infrared fluorescence imaging using CW800‐CA for intraoperative delineation of the course of the ureters is the next step. Such a pilot study should focus on a more targeted dose‐finding of the administered dye, as even a lower dose than 3 mg/ml (used in experiment 2) might be sufficient. Conclusion This technical report describes the possibility of near‐infrared fluorescence delineation of the ureters using a commercially available laparoscopic fluorescence imaging system and CW800‐CA in a pig model. 84
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