Firefly in the OR

In the heat of the summer, fireflies can be seen outside after dark. At Shawnee Mission Medical Center (SMMC), Robotic Surgeon Scott Montgomery, MD, is seeing a different type of  Firefly™ in the operating room (OR).

Montgomery, who performed his first robotic urologic surgery in 2003, believes the Firefly technology is a tremendous advancement in robotic-assisted surgery with several patient benefits. The enhanced imaging incorporates a green colored dye called IndoCyanine Green (ICG) to help identify the renal vessels and allows for selective arterial clamping during kidney sparing surgery for patients who have kidney cancer. Montgomery and his partners at Kansas City Urology Care are among a select group of surgeons in the world to utilize this technology. SMMC was one of 85 medical institutions in the nation to implement Firefly in the fall of 2011. 

During the procedure, the ICG is injected intravenously. The specially-designed camera can view the images of tissue and surrounding blood vessels illuminated by the dye.

The florescence imaging capabilities with Firefly combined with the three dimensional HD camera allow for real time identification of the vascular anatomy in relation to the kidney tumor. As the blood supply to the kidney tumor is severed, the remainder of the kidney is never interrupted.
 
“A meticulous and precise dissection of the tumor is completed while avoiding any damage to the kidney and healthy tissue,” said David Emmott, MD, director of robotic surgery at SMMC.

In the past, patients undergoing open kidney removal (nephrectomy) had very large incisions since partially removing it was not an option. At SMMC, Montgomery and his partners perform partial nephrectomy with the help of the da Vinci™ robot. Firefly  is the latest technology available to help with blood supply and differentiate cancerous tissue from normal tissue.

It is not uncommon to find many of Montgomery’s patients walking the halls of SMMC the day after a partial nephrectomy.

In October, tune in as SMMC premieres its latest surgical webcasts featuring advanced techniques in gynecologic and urologic surgery. Each 30-minute program will feature interviews with both patients and physicians, along with surgical footage taken straight from the operating room. The urologic procedure will highlight real-time Firefly™ that allows surgeons to see and assess anatomy better than the naked eye.