Intraoperative imaging using near-infrared (NIR) fluorescence is a relatively new technique that can be used to visualize tumor tissue, sentinel nodes and vital anatomical structures. This thesis... Show moreIntraoperative imaging using near-infrared (NIR) fluorescence is a relatively new technique that can be used to visualize tumor tissue, sentinel nodes and vital anatomical structures. This thesis is divided in three parts. In part one the ability to visualize surgical margins using NIR fluorescence imaging is demonstrated. Tumor visualization is established using the clinically approved contrast agent indocyanine green, as well as newly developed tumor targeted probes. The proportion of laparoscopic procedures has steadily increased over the last two decades. A challenging aspect of this conversion to minimal invasive surgery is the lack of tactile information, making it of particular interest for the development and improvement of laparoscopic NIR fluorescence imaging systems. Part two focusses on the clinical implementation of NIR fluorescence guided sentinel lymph node mapping for several indications (e.g. breast, skin and vulvar cancer). Besides visualization of structures that need to be resected (e.g. tumor tissue or sentinel nodes), NIR fluorescence has also the potential to be of value for the identification of structures that should be spared. In part three, we demonstrate the first-in-human application of NIR fluorescence guided ureteral visualization, and also the optimization of bile duct imaging for routine laparoscopic cholecystectomies. Show less
