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Robotically assisted peritoneal mesometrial resection (PMMR) in endometrial cancer supported by ICG labeling of the compartmental lymphatic system.

ABSTRACT: •Peritoneal mesometrial resection is a compartment based radical hysterectomy in endometrial cancer•ICG staining of the lymph-vessel system facilitates identification of compartment borders•Fluorescence based HD-video documentation supports education in surgery of endometrial cancer.

SUBMITTER: Kimmig R

PROVIDER: S-EPMC4899481 | biostudies-literature | 2016 Apr

REPOSITORIES: biostudies-literature

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Robotically assisted peritoneal mesometrial resection (PMMR) in endometrial cancer supported by ICG labeling of the compartmental lymphatic system.

Kimmig Rainer R Aktas Bahriye B Buderath Paul P Heubner Martin M

Gynecologic oncology reports 20160319

•Peritoneal mesometrial resection is a compartment based radical hysterectomy in endometrial cancer•ICG staining of the lymph-vessel system facilitates identification of compartment borders•Fluorescence based HD-video documentation supports education in surgery of endometrial cancer. ...[more]

PMID: 27331131

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Technique of ICG-guided Targeted Compartmental Pelvic Lymphadenectomy (TCL) combined with Pelvic Peritoneal Mesometrial Resection (PMMR) for locoregional control of endometrial cancer - A proposal.

Project description:•PMMR is a compartment based radical hysterectomy in endometrial cancer.•Pelvic PMMR may be combined with ICG guided Targeted Compartmental Lymphadenectomy (TCL).•Video of Pelvic PMMR and TCL technique may be basis for a prospective study.

| S-EPMC5412086 | biostudies-literature

Cancer field surgery in endometrial cancer: peritoneal mesometrial resection and targeted compartmental lymphadenectomy for locoregional control.

Project description:ObjectivePeritoneal mesometrial resection (PMMR) plus targeted compartmental lymphadenectomy (TCL) aims at removal of the locoregional cancer field in endometrial cancer (EC). Optimal locoregional control without adjuvant radiotherapy and acceptable surgical morbidity should be achieved concomitantly sparing systematic lymphadenectomy (LNE) for most of the patients.MethodsWe evaluated data from 132 patients treated for EC. Out of these, between January 2017 and June 2020 we performed robotic PMMR and TCL on 51 women. We present the first data of feasibility and safety of the procedure as well as preliminary oncological results.ResultsThe 51 patients treated with robotic PMMR and TCL showed comparable morbidity to classic laparoscopic hysterectomy or PMMR without LNE. One intraoperative complication occurred. Postoperative complications grade 3 and higher occurred in 2 cases (3.9%). One of these (85 years old) experienced grade 5 following pulmonary embolism with lysis therapy. Fifteen patients (29.4%) could be spared complete LNE. The rate of adjuvant radiotherapy was 3.9% in our collective (n=2), compared to 39.2% of patients (n=20) eligible for irradiation according to international guidelines. In a mean follow-up time of 15 months (0-41), no locoregional recurrences were observed, although three patients showed distant relapse.ConclusionsOur data suggest that robotic PMMR and pelvic TCL can be performed regardless of BMI and comorbidities without a relevant increase in surgical morbidity. Moreover, despite a relevant reduction of adjuvant radiotherapy, first follow-up data hint at a favorable locoregional recurrence rate in the reported cohort.

| S-EPMC7767647 | biostudies-literature

Surgical anatomy of the ligamentous mesometrium and robotically assisted ICG-guided resection in cervical cancer.

Project description:The ligamentous mesometrium is a 3-dimensional structure consisting of a rectouterine/-vaginal part with attachment to the anterior lateral mesorectum and a sacrouterine part surrounding the mesorectum attached to the pelvic fascia and the mesorectum dorsolaterally. The lymphatic network draining the posterior cervix connected caudally ventrally to the deep venous lymph network of the vascular mesometrium is running at the lateral surface of the sacrouterine part and dorsomedially of the inferior hypogastric plexus; it drains to the deep internal iliac, prespinal and preischiadic nodes.

| S-EPMC5274698 | biostudies-other

Left paraaortic, inframesenteric lymphadenectomy preserving the superior hypogastric plexus supported by indocyanine green (ICG) labeling of the lymphatic compartment in cervical cancer.

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| S-EPMC5030370 | biostudies-literature

Ferrocene-Supported Compartmental Ligands for the Assembly of 3d/4f Complexes.

Project description:Site-specific coordination ligands, also known as compartmental ligands, have been used for the preparation of heterometallic complexes. These ligands, by virtue of possessing specific binding sites, can encapsulate different metal ions in their coordination pockets. Such compartmental ligands have been widely used for the preparation of heterometallic 3d/4f complexes which have applications in molecular magnetism. This Review summarizes our efforts in the use of ferrocene-based compartmental ligands for the preparation of heterometallic 3d/4f complexes, some of which are single-molecule or single-ion magnets.

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In vivo albumin labeling and lymphatic imaging.

Project description:The ability to accurately and easily locate sentinel lymph nodes (LNs) with noninvasive imaging methods would assist in tumor staging and patient management. For this purpose, we developed a lymphatic imaging agent by mixing fluorine-18 aluminum fluoride-labeled NOTA (1,4,7-triazacyclononane-N,N',N''-triacetic acid)-conjugated truncated Evans blue ((18)F-AlF-NEB) and Evans blue (EB) dye. After local injection, both (18)F-AlF-NEB and EB form complexes with endogenous albumin in the interstitial fluid and allow for visualizing the lymphatic system. Positron emission tomography (PET) and/or optical imaging of LNs was performed in three different animal models including a hind limb inflammation model, an orthotropic breast cancer model, and a metastatic breast cancer model. In all three models, the LNs can be distinguished clearly by the apparent blue color and strong fluorescence signal from EB as well as a high-intensity PET signal from (18)F-AlF-NEB. The lymphatic vessels between the LNs can also be optically visualized. The easy preparation, excellent PET and optical imaging quality, and biosafety suggest that this combination of (18)F-AlF-NEB and EB has great potential for clinical application to map sentinel LNs and provide intraoperative guidance.

| S-EPMC4291643 | biostudies-literature

Resin supported acyl carrier protein labeling strategies.

Project description:The post-translational modifying enzymes phophopantetheinyl transferase and acyl carrier protein hydrolase have shown utility in the functional modification of acyl carrier proteins. Here we develop these tools as immobilized biocatalysts on agarose supports. New utility is imparted through these methods, enabling rapid and label-independent protein purification. Immobilization of acyl carrier protein is also demonstrated for rapid activity assays of these 4'-phosophopantetheine modifying enzymes, displaying a particular advantage in the case of phosphopantetheine removal, where few orthogonal techniques have been demonstrated. These tools further enrich the suite of functional utility of 4'-phosophopantetheine chemistry, with applications to protein functionalization, materials, and natural product biosynthetic studies.

| S-EPMC4012645 | biostudies-literature

Total mesometrial resection (TMMR) for cervical cancer FIGO IB-IIA: first results from the multicentric TMMR register study.

Project description:ObjectiveThe surgical concept of total mesometrial resection (TMMR) and therapeutic lymphadenectomy (tLNE) for the treatment of early cervical cancer is based on the ontogenetic cancer field model. Unicentric data show excellent locoregional control rates without adjuvant chemoradiation. However, there are so far no prospective, multicentric data supporting the method.MethodsThe multicentric TMMR register study was designed to answer the question whether the concept of TMMR+tLNE could be transferred to different centers and surgeons without compromising the outstanding oncologic results described in a unicentric setting.ResultsIn 116 patients with cervical cancer stages IB-IIA, (International Federation of Gynecology and Obstetrics [FIGO] 2018), who underwent TMMR/tLNE, 25.0% were lymph node-positive. pT stages were pT1a in 3 patients (2.6%), pT1b1 in 82 (70.7%), pT1b2 in 18 (15.5%), pT2a in 4 (3.5%) and pT2b in 9 (7.8%). The overall recurrence rate was 7.8% in a median follow-up time of 24 months (6-80). Locoregional recurrences occurred in 6.0% of patients. One patient (0.9%) died from the disease during the observation period.ConclusionThese are the first multicentric data on the surgical concept of TMMR and tLNE for the treatment of cervical cancer FIGO IB-IIA. We were able to reproduce the excellent oncologic data described for the method albeit with a relatively short median observation time. A randomized controlled trial seems warranted to definitely establish TMMR+tLNE as the method of choice for the treatment of early cervical cancer.Trial registrationClinicalTrials.gov Identifier: NCT01819077.

| S-EPMC8728671 | biostudies-literature

Aortic utero-ovarian sentinel nodes and left infrarenal aortic lymph node dissection by ICG supported navigation.

Project description:•Visualization of paraaortic sentinel compartments in endometrial cancer•Nerve sparing dissection of left paraaortic infrarenal lymph compartment•Educational video may be basis for standardization of paraaortic sentinel node dissection.

| S-EPMC5310174 | biostudies-literature

Anatomical investigation of the pelvic urogenital fascia in 10 formalin-fixed female cadavers: novel insights into the laparoscopic total mesometrial resection.

Project description:PurposePrevious anatomical studies of the urogenital fascia (UGF) have focused on males, and there is a lack of relevant anatomical studies on the distribution of the extraperitoneal UGF in females.MethodsIn this investigation, guided by the embryonic development of the female urogenital system, the ventral pelvic fascia structure of 10 female cadavers was dissected, and the distribution and morphology of female extraperitoneal UGF were observed, recorded in text, photographs and video, and 3D modeling was performed.ResultsWe find that in the female extraperitoneal space there is a migratory fascial structure, the UGF, which surrounds the urogenital system and extends from the perinephric region to the pelvis along with the development of the urogenital organs. The two layers of the UGF are composed of loose connective tissue rich in fat that surrounds the urogenital organs, their accessory vascular structures, and the nerves of the abdominopelvic cavity. In the pelvis, it participates in the formation of the ligamentous structures around the rectum and uterus. Finally, it surrounds the bladder and gradually moves into the loose connective tissue of the medial umbilical fold.ConclusionsSorting out the distribution characteristics of UGF has some reference value for studying the metastasis of gynecological tumors, the biomechanical structure of the female pelvis, and the surgical methods of gynecology, colorectal surgery, and hernia surgery.

| S-EPMC10612149 | biostudies-literature

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