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2022-VA-1284-ESGO Indocyanine green as a learning tool for para-aortic laparoscopic lymphadenectomy after sentinel lymph node detection in ovarian cancer
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  1. Ana Conde Adán,
  2. Sonsoles Alonso,
  3. María F Chereguini,
  4. Carmen Yelo,
  5. Virginia Corraliza,
  6. Rafael Navarro,
  7. Marisa Argente and
  8. Francisco Javier De Santiago Garcia
  1. Gynecology, MD Anderson Cancer Center, Madrid, Spain

Abstract

Introduction/Background Indocyanine green is being widely used in gynecology oncology; specially in sentinel node detection in endometrial cancer. New applications are being studied, as sentinel node detection in ovarian cancer.

Methodology We are performing indocyanine green laparoscopic sentinel node detection in a woman affected by ovarian cancer. She had been diagnosed after an anexectomy for a suspicious ovarian mass in another center. We inject indocyanine green in the infundibolopelvic and the ovaric ligament stumps through the abdominal wall.

Results After the detection of the sentinel nodes we perform the lymphadenectomy with the fluorescent camera on. We perceive the anatomical marks more clearly, the difference between the vessels and the lymphatic tissue became more individualized. Avoiding vessel injury is one of the challenges in the learning curve for para-aortic lymphadenectomy Anatomical variations in the para-aortic region occurred in one third of the women.

Conclusion Indocyanine green is a useful tracer for sentinel node detection. We propose that it could be a learning tool for beginners in the lymphadenectomy technique and in cases of special difficulty, for example in anatomical variations.

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