SLNB Melanoma
Where are the sentinel lymph nodes expected?
The search for the sentinel nodes in melanoma patients (sentinel lymph node biopsy, SLNB) is based on your profound orientation, 3-D capabilities, and the interpretation of gamma probe readings while moving over the operation site. The declipseSPECT solution enhances your gamma probe detection capabilities and enables for the first time worldwide intraoperative 3-D imaging, 3-D high resolution image viewing and depth measurements for soft tissue targets. 3-D imaging is in direct correlation with the anatomy, enabling the guidance of surgical instruments for a direct approach to sentinel nodes. After dissection of the sentinel lymph node the system provides a quality assurance and a tool for documentation of the complete removal of radioactive structures. Your protocol with 3-D imaging of lymph nodes in the operating room provides minimal invasiveness and direct access.
3-D Melanoma imaging in the operation room before intervention:
- Full 3-D image acquisition ensures precise identification and localization also for sentinel nodes close to the injection site, as well as in remote areas (e.g. axilla, groin, abdominal wall, neck)
- Direct correlation with anatomy enables orientation, referencing, and planning of minimally invasive interventions
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| Figure: Two sentinel node conglomerates visible in its anatomical context in 3-D augmented on the real-time video image |
Navigation to the sentinel nodes during intervention:
- Orientation, localization and identification in 3-D ensures safety during procedure
- Depth measurement provides direct and minimally invasive access
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| Figure: Dissection of sentinel nodes using the video overlay and navigation view |
Control of complete resection of all sentinel nodes:
- 3-D scan enables confirmation of complete removal of radioactive sentinel nodes
- Documentation provides transparent and reliable follow up treatments
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| Figure: Documentation shows that there are no remaining sentinel nodes with radioactivity in the axilla |
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ROLL and SNOLL Breast
How can non palpable regions be safely localized and resected?
The resection of non palpable lesion using ROLL (radio-guided occult lesion localization) and its combination with SLNB (SNOLL) are challenging tasks which are based on your profound orientation, 3-D capabilities, and the interpretation of gamma probe readings while moving over the operation situs. The declipseSPECT solution enhances your gamma probe detection capabilities and enables for the first time worldwide intraoperative 3-D imaging, 3-D high resolution image viewing and depth measurements for soft tissue targets. The 3-D imaging is in direct correlation with the anatomy, enabling guidance of surgical instruments for a direct approach to the radioactive marked seeds. After dissection of the tumor mass, the system provides a scan of the area to visualize during surgery the 3-D distribution of radioactivity in the tumor mass. SurgicEye solutions support your vision of minimal invasive and residual free tumor resection by imaging the structures in all three dimensions over time.
3-D Breast Imaging in the operation room before intervention:
- Full 3-D image acquisition enables precise identification and localization
- Direct correlation with anatomy provides orientation and referencing
- Overview of activity distribution ensures detection/identification of the labeled tumors, and the case of SNOLL, the injection site, and sentinel nodes, even if they are covering each other (it eliminates shadowing effects)
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| Figure: 3-D image of the radioactivity distribution in palpable primary tumor for sentinel node marking and in a non palpable lesion for radio-guided occult lesion localization |
Navigation to the non-palpable tumors during intervention:
- Orientation, localization and identification in 3-D ensure safety during procedure
- Depth measurement provides direct and minimally invasive access
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| Figure: image overlay for correlation of the 3-D image with the anatomy of the patient. |
Control of clean border resection of all non-palpable tumors:
- 3-D scan provides confirmation of complete removal of radioactively marked tumors
- Enables specimen examination after resection and boundary control through direct visual evaluation
- Documentation enables transparent and reliable follow up treatments
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| Figure: control of the specimen to confirm the seed location within it and for direct estimation of tumor borders before waiting for the pathology results |
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