New Firefly imaging technology prevents the removal of unnecessary lymph nodes and lowers the risk of lymphedema after endometrial cancer surgery.
Endometrial cancer, which occurs in the lining of the uterus, is the most common gynecological cancer in the U.S. According to the American Cancer Society, more than 65,000 new endometrial cancer cases are expected to be diagnosed this year. During the month of March, National Endometriosis Awareness Month, we work to raise awareness of this debilitating disease and the newest treatments.
Surgery is usually the first line of treatment for endometrial cancer and most often involves a total hysterectomy, including removing the ovaries, fallopian tubes, uterus and cervix. The gynecological cancer care specialists at Hackensack University Medical Center often perform this procedure using the daVinci® robotic surgical system, which involves only a few small incisions in the abdomen.
In addition to the daVinci robotic surgical technology, the women’s robotic reproductive and gynecological surgery specialists at Hackensack use a near-infrared imaging system called Firefly to assess whether the cancer has begun to spread, and to improve quality of life for patients after endometrial cancer surgery.
How the daVinci Robotic Surgical System Works:
Two or three of the system’s robotic arms hold small surgical instruments, and another arm holds a small video camera.
The instruments and camera are inserted into the body through small incisions in the abdomen.
The camera transmits a magnified 3D video image of the pelvic anatomy onto a screen at the surgical console, where the surgeon sits and controls the robot.
The small incisions and smaller surgical instruments used during robotic surgery—plus the enhanced surgical visibility—are often associated with patient benefits such as:
Lower risk of complications
According to Ami P. Vaidya, M.D., Firefly allows surgeons to provide patients with benefits that continue even after healing is complete. “Firefly allows us to assess the patient’s pelvic lymph nodes to find the sentinel lymph nodes, or the first lymph nodes where the cancer is likely to spread,” Dr. Vaidya says. “By removing only the sentinel lymph nodes instead of removing all of the lymph nodes in the tumor area, we can lower the patient’s risk of developing lymphedema.”
Lymphedema is a complication that can occur anywhere 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 experience uncomfortable, chronic leg swelling due to a buildup of lymph fluid that cannot drain. In some cases, lymphedema requires additional surgical treatment.
“Lymphedema after surgery can significantly impair a patient’s quality of life,” Dr. Vaidya says. “When it comes to endometrial cancer, we not only have to think about how to remove the cancer, but we always have to look for ways to improve quality of life after surgery.”
How Firefly Works:
At the beginning of the surgery, the surgeon injects a fluorescent dye called ICG into the patient’s cervix and uterus.
The dye makes its way into the sentinel lymph nodes.
When the surgeon switches the daVinci surgical system’s camera to “Firefly mode” from the surgical console, the sentinel lymph nodes appear green—making them easier to see and accurately remove.
Hackensack received approval from the National Comprehensive Cancer Network (NCCN) to use Firefly in conjunction with surgery to treat Stage 1 endometrial cancer in patients with a low or high risk of sentinel lymph node involvement.
“Not every hospital that has a daVinci robotic surgical system has Firefly, so we are privileged to be able to use this technology when caring for our patients,” Dr. Vaidya says.
Next Steps & Resources:
Meet our sources: Ami P. Vaidya, M.D. To make an appointment with Dr. Vaidya or another doctor near you, call 800-822-8905 or visit our website.
Learn more about gynecological cancer care at Hackensack Meridian Health
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