Laparoscopic Resection of Sigmoid Colon Cancer with Preoperative Fluorescent Marking Clips—Report of a Case—

Abstract

In laparoscopic colorectal surgery, preoperative tumor-site marking is important to determine transection lines, where the accuracy and the safety are required. Intraoperative endoscopy or ink injection method has commonly been used. This paper deals with a case of sigmoid colon cancer in which we performed preoperative marking using fluorescent marking clips (ZEOCLIP FS^®, Zeon Medical, Tokyo), identified the tumor location by near infrared camera intraoperatively, and conducted laparoscopic sigmoidectomy.

A 71-year-old man presented with a sigmoid colon polyp at a screening test with lower gastrointestinal endoscopy and was diagnosed with sigmoid colon cancer following EMR with pathological study. As he was found having submucosal invasion with the size of 2400μm, he was referred to our hospital for the purpose of undergoing additional resection. On the day before surgery, we placed four fluorescent marking clips in the vicinity of the anal side of the tumor to make marking of the lesion. During surgery, we could easily confirm these clips by direct vision through the serosa by near infrared camera. No adverse episodes occurred at clipping with the fluorescent clips nor escaping of the clips, and no intraoperative complications occurred. The safety of this method was proved.