Contents

The article discusses the advancement in robotic sentinel lymph node (SLN) mapping for endometrial cancer staging using a novel sensitive Firefly mode integrated into the da Vinci Xi Surgical System. Traditional lymphadenectomy, which carries increased morbidity without improving survival for early-stage disease, is being replaced by SLN mapping and biopsy to minimize risks. The sensitive Firefly mode enhances fluorescent sensitivity, allowing for the detection of indocyanine green (ICG) at lower concentrations and through deeper tissue, which may improve the identification of SLN channels, especially in patients with more adiposity. However, when using sensitive Firefly, surgeons cannot move instruments or activate energy, and the anatomy not containing ICG remains unilluminated. The potential of high sensitivity near-infrared imaging to improve bilateral mapping rates and reduce operative time associated with SLN biopsy through better recognition of lymphatic pathways is a promising direction for future research. 

Citation

Anastasio MK, Darling A, Rossi EC. Robotic sentinel lymph node mapping with sensitive Firefly for endometrial cancer staging. Int J Gynecol Cancer. 2024 Mar 13:ijgc-2023-005138. 

Link

https://ijgc.bmj.com/content/early/2024/03/13/ijgc-2023-005138.long