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Peer-reviewedCC BY-NC-NDJournal of the anus, rectum and colon

Subserosal Indocyanine Green Mapping in Colorectal Surgery Using an Adjustable Laparoscopic Injection Needle.

  • Jun Nagata1
  • Hiroto Sannomiya1
  • Kensuke Nitta1
  • Atsuhiro Koga1
  • Yasuki Akiyama1
  • Masumi Yamauchi1
  • Yasuhisa Mori1
  • Nagahiro Sato1
  • Toshihisa Tamura1
  • Kazunori Shibao1
  • Keiji Hirata1
  1. 1First Department of Surgery, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
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Abstract

Indocyanine green (ICG) fluorescence imaging is increasingly used in colorectal surgery, but reliable intraoperative subserosal injection for lymphatic mapping remains technically challenging because puncture depth control and prevention of dye spillage are essential. We developed a standardized subserosal ICG mapping technique using an adjustable laparoscopic injection needle under direct laparoscopic or robotic visualization. The serosa adjacent to the tumor is punctured with the needle tip adjusted to local bowel wall thickness, and ICG is delivered using a saline-ICG-saline sandwich technique. To minimize contamination, the outer sheath of a suction tube is positioned close to the puncture site as a protective guide for the injection needle, allowing immediate re-sheathing after injection; laparoscopic gauze is added when necessary. Fluorescence imaging is then performed to visualize lymphatic flow and fluorescent nodal basins. In our initial 10-patient experience, detection was achieved in 9 patients without puncture-related complications.

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Cite

BibTeXRIS
BibTeX
@article{nagata2026subserosal,
  title = {{Subserosal Indocyanine Green Mapping in Colorectal Surgery Using an Adjustable Laparoscopic Injection Needle.}},
  author = {Jun Nagata and Hiroto Sannomiya and Kensuke Nitta and Atsuhiro Koga and Yasuki Akiyama and Masumi Yamauchi and Yasuhisa Mori and Nagahiro Sato and Toshihisa Tamura and Kazunori Shibao and Keiji Hirata},
  journal = {Journal of the anus, rectum and colon},
  year = {2026},
  month = oct,
  doi = {10.23922/jarc.2026-049},
  url = {https://europepmc.org/article/MED/42952890},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - Subserosal Indocyanine Green Mapping in Colorectal Surgery Using an Adjustable Laparoscopic Injection Needle.
AU  - Jun Nagata
AU  - Hiroto Sannomiya
AU  - Kensuke Nitta
AU  - Atsuhiro Koga
AU  - Yasuki Akiyama
AU  - Masumi Yamauchi
AU  - Yasuhisa Mori
AU  - Nagahiro Sato
AU  - Toshihisa Tamura
AU  - Kazunori Shibao
AU  - Keiji Hirata
PY  - 2026
DA  - 2026/10/25
JO  - Journal of the anus, rectum and colon
DO  - 10.23922/jarc.2026-049
UR  - https://europepmc.org/article/MED/42952890
AB  - Indocyanine green (ICG) fluorescence imaging is increasingly used in colorectal surgery, but reliable intraoperative subserosal injection for lymphatic mapping remains technically challenging because puncture depth control and prevention of dye spillage are essential. We developed a standardized subserosal ICG mapping technique using an adjustable laparoscopic injection needle under direct laparoscopic or robotic visualization. The serosa adjacent to the tumor is punctured with the needle tip adjusted to local bowel wall thickness, and ICG is delivered using a saline-ICG-saline sandwich technique. To minimize contamination, the outer sheath of a suction tube is positioned close to the puncture site as a protective guide for the injection needle, allowing immediate re-sheathing after injection; laparoscopic gauze is added when necessary. Fluorescence imaging is then performed to visualize lymphatic flow and fluorescent nodal basins. In our initial 10-patient experience, detection was achieved in 9 patients without puncture-related complications.
SN  - 2432-3853
ER  -