Firefly Fluorescence Imaging helps surgeons determine sentinel lymph nodes throughout robotic endometrial most cancers surgical procedure


Newswise – Endometrial cancer, which occurs in the lining of the uterus, is the most common gynecological cancer in the United States. The American Cancer Society estimates that more than 65,000 new cases of endometrial cancer are expected to be diagnosed in 2020.

Surgery is usually the first line of treatment for endometrial cancer and most often involves a total hysterectomy, including the removal of the ovaries, fallopian tubes, uterus, and cervix. The specialists in gynecological cancer treatment at Hackensack Meridian Hackensack University Medical Center often perform this procedure using the da Vinci robotic surgical system, which requires only a few small incisions in the abdomen.

In addition to state-of-the-art da Vinci robotic surgery technology, our women’s reproductive and gynecological robotic surgery specialists use a near-infrared imaging system called Firefly to assess sentinel lymph nodes and improve the quality of life for patients after endometrial cancer surgery.

Benefits of Firefly

Da Vinci’s robotic surgery system is equipped with three robotic arms that hold surgical instruments and one robotic arm with a small camera. During the operation, the instruments and camera are inserted into the patient’s abdomen through several small incisions. The camera projects a 3D video image of the operating area onto a screen on the special operating console so that the surgeon can precisely guide the surgical instruments.

The small incisions and smaller surgical instruments used during robotic surgery, as well as the improved visibility of the surgical procedure, are often associated with patient benefits such as: B. Faster recovery, less pain, less risk of complications and less scarring.

According to Dr. Ami P. Vaidya, Vice Chairman of the Department of Obstetrics and Gynecology; Co-Head of the Department of Gynecological Oncology; Firefly is the director of Minimally Invasive and Robotic Gynecological Surgery, enabling surgeons to provide patient benefits that persist even after healing is complete.

“With Firefly we can examine the patient’s pelvic lymph nodes to find the sentinel lymph nodes, or the first lymph nodes to receive lymph drainage from a tumor,” said Dr. Vaidya. “By removing only the sentinel lymph nodes rather than performing a full lymphadenectomy to remove all of the lymph nodes in the tumor area, we can reduce the patient’s risk of developing lymphedema.”

Lymphedema is a complication that can occur between a few days and a few years after surgery to remove lymph nodes. The more lymph nodes that are removed, the higher the risk of developing lymphedema. Patients who develop lymphedema after endometrial cancer surgery suffer from uncomfortable chronic leg swelling due to a build-up of lymph that cannot drain. In some cases, lymphedema requires additional surgical treatment.

“Post-operative lymphedema can have a significant impact on a patient’s quality of life,” said Dr. Vaidya. “When it comes to endometrial cancer, we don’t just have to think about a cure, we always need to look for ways to improve the quality of life after curative surgery.”

How Firefly works

Hackensack University Medical Center has received approval from the National Comprehensive Cancer Network (NCCN) to use Firefly in conjunction with surgery to treat Stage 1 endometrial cancer in patients at low or high risk of sentinel lymph node involvement.

At the beginning of the surgery, the surgeon injects a fluorescent dye called ICG into the patient’s cervix and uterus. The dye is absorbed by the patient’s lymph channels and reaches the sentinel lymph nodes.

Hackensack University Medical Center’s da Vinci robotic surgery systems are specially equipped with near-infrared technology that triggers the fluorescence of the injected dye. When the surgeon switches the da Vinci Surgical System camera to “Firefly Mode” from the surgical console, the sentinel lymph nodes appear green, making them easier to see and to remove accurately.

“Not every hospital with a da Vinci robotic surgical system has Firefly, so we have the privilege of using this technology to care for our patients,” said Dr. Vaidya.

Study shows excellent results

Mira Hellmann, MD, together with colleagues for gynecological oncology, Dr. Vaidya and Merieme Klobocista, MD, conducted an in-house study of 128 patients who had undergone robotic endometrial cancer surgery with sentinel lymph node identification using Firefly. The study showed that Firefly technology helped accurately identify and remove sentinel lymph nodes.

“We want our patients to know that we are committed to high quality surgical care. That means we take the time to demonstrate the success of new technologies through research,” said Dr. Vaidya.

Endometrial Cancer Integrative Robotic Surgery

There is a new way to treat endometrial, and other uterine cancers, using robotic surgery, targeted molecular therapies where needed, and integrative holistic support.  It might help you to review your 21st century options:  Uterine Endometrial Cancer Treatment Options


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