New Firefly technology lights up more precise kidney sparing surgery

June 05, 2012

(Washington, DC) -- A surgical technology called Firefly is shedding new light on kidney cancers and helping doctors at MedStar Georgetown University Hospital remove tumors more safely and more efficiently while sparing the rest of the healthy kidney.

"The addition of Firefly fluorescence during robotic surgery improves our ability to remove kidney tumors when before we might have had to remove the whole kidney," said Keith Kowalczyk, MD, urologist and robotic surgeon. "Firefly, which essentially utilizes a dye that lights up in "firefly green" when using a specialized fluoroscopic camera, can show us the difference between cancerous and healthy tissue and helps us see the blood supply to the tumor. It lights up parts of the kidney and its blood supply we couldn't see this well before."

This new innovation uses the minimally-invasive precision of the da Vinci Surgical System, and adds the second component of Firefly fluorescence imaging. MedStar Georgetown is one of the first hospitals in the DC region to use this new technology.

When Eugene Carter of Washington, D.C. was diagnosed with kidney cancer, the decision to have robotic surgery by Dr. Kowalczyk while utilizing fluorescence imaging seemed the obvious choice.

"I'm 70, and with advanced age the hazards of surgery can increase, so I wanted the least invasive surgery possible," explained Mr. Carter. "The robotics provide more steadiness and precision, and I wanted my surgeon to be as steady and as precise as possible. It seems to me this is just a much wiser system."

How does it work? The Firefly technology uses near-infrared imaging to detect an injected tracer dye of indocyanine green (ICG) in the blood.

During surgery, urologists use the Firefly system at three different stages of the procedure. The first injection of the dye into the IV by the anesthesiologist gives a detailed picture of the blood supply to the kidney.

"Up to 25-percent of patients might have extra renal arteries that are not always obvious on a CT scan or MRI, so the Firefly can help us see these arteries. This helps us ensure that all of the blood supply to the kidney is accounted for and controlled prior to the removal of the tumor, and can therefore decrease blood loss," explained Dr. Kowalczyk.

The second injection of dye helps the surgeon differentiate between the cancerous tissue and the normal kidney tissue, which can allow for better tumor removal and potentially a lower risk of leaving any cancer behind. Finally, after the tumor has been removed and the kidney has been repaired, the dye can again be injected again to ensure that the blood supply to the kidney has been properly restored.

Besides the known benefits of robotic minimally-invasive surgery--including smaller incisions, less blood loss, less postoperative pain, shorter hospital stays, and earlier returns to work--the addition of the Firefly system can improve patient outcomes even further.

"Additionally, the ability to better distinguish between tumor tissue and normal kidney tissue may lead to a lower risk of leaving any tumor behind, and therefore better long-term cancer control," said Dr. Kowalczyk.

According to the American Cancer Society, kidney cancer is among the 10 most common cancers among both men and women. The ACS estimates that about 64,770 new cases of kidney cancer will occur in 2012, and about 13,570 people will die from the disease.

"I'm so glad I was able to keep my kidney," said Mr. Carter. "Without this new system, my kidney might not have been able to be saved."
-end-


MedStar Georgetown University Hospital

Related Cancer Articles from Brightsurf:

New blood cancer treatment works by selectively interfering with cancer cell signalling
University of Alberta scientists have identified the mechanism of action behind a new type of precision cancer drug for blood cancers that is set for human trials, according to research published in Nature Communications.

UCI researchers uncover cancer cell vulnerabilities; may lead to better cancer therapies
A new University of California, Irvine-led study reveals a protein responsible for genetic changes resulting in a variety of cancers, may also be the key to more effective, targeted cancer therapy.

Breast cancer treatment costs highest among young women with metastic cancer
In a fight for their lives, young women, age 18-44, spend double the amount of older women to survive metastatic breast cancer, according to a large statewide study by the University of North Carolina at Chapel Hill.

Cancer mortality continues steady decline, driven by progress against lung cancer
The cancer death rate declined by 29% from 1991 to 2017, including a 2.2% drop from 2016 to 2017, the largest single-year drop in cancer mortality ever reported.

Stress in cervical cancer patients associated with higher risk of cancer-specific mortality
Psychological stress was associated with a higher risk of cancer-specific mortality in women diagnosed with cervical cancer.

Cancer-sniffing dogs 97% accurate in identifying lung cancer, according to study in JAOA
The next step will be to further fractionate the samples based on chemical and physical properties, presenting them back to the dogs until the specific biomarkers for each cancer are identified.

Moffitt Cancer Center researchers identify one way T cell function may fail in cancer
Moffitt Cancer Center researchers have discovered a mechanism by which one type of immune cell, CD8+ T cells, can become dysfunctional, impeding its ability to seek and kill cancer cells.

More cancer survivors, fewer cancer specialists point to challenge in meeting care needs
An aging population, a growing number of cancer survivors, and a projected shortage of cancer care providers will result in a challenge in delivering the care for cancer survivors in the United States if systemic changes are not made.

New cancer vaccine platform a potential tool for efficacious targeted cancer therapy
Researchers at the University of Helsinki have discovered a solution in the form of a cancer vaccine platform for improving the efficacy of oncolytic viruses used in cancer treatment.

American Cancer Society outlines blueprint for cancer control in the 21st century
The American Cancer Society is outlining its vision for cancer control in the decades ahead in a series of articles that forms the basis of a national cancer control plan.

Read More: Cancer News and Cancer Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.