In a historic milestone, Hospital Sultan Abdul Aziz Shah (UPM) has successfully conducted its first Laparoscopic Sentinel Node Biopsy for endometrial cancer using Indocyanine Green (ICG) earlier this week. This innovative procedure marks a significant advancement in the field of gynecological oncology and offers new hope for improved diagnosis and treatment of endometrial cancer.

Endometrial cancer is the most common cancer of the female reproductive system, and early detection plays a crucial role in increasing treatment success rates. Traditional methods of assessing the spread of cancer often involve extensive lymph node dissections, leading to potential complications and longer recovery times for patients.

The Sentinel Node Biopsy (SNB) technique, now employed at Hospital Sultan Abdul Aziz Shah UPM, revolutionizes the approach in the management of endometrial cancer by targeting the sentinel lymph nodes, which are the first nodes to receive drainage from a tumour. By using Indocyanine Green, a fluorescent dye that selectively illuminates lymphatic vessels and nodes, surgeons can precisely identify and biopsy these critical nodes with unparalleled accuracy.

Dr. Ahmad Shuib Yahaya, the lead gynecological oncologist at HSAAS UPM, spearheaded the team that performed a Total Laparoscopic Hysterectomy and Sentinel Node Biopsy for a case of early endometrial cancer on 9^th January 2024. He expressed his enthusiasm about the successful implementation of SNB with ICG, stating, "This is a game-changer for endometrial cancer patients in the country. By pinpointing the sentinel nodes more accurately, we can streamline the diagnostic process and potentially spare patients unnecessary potentially harmful procedures."

The procedure involves injecting ICG at the uterine cervix, allowing surgeons to visualize the lymphatic drainage pathways in real-time using near-infrared imaging during a minimally invasive surgery. The sentinel nodes, identified by their fluorescent glow, are then carefully removed for pathological examination by frozen section. This technique had been recommended in various clinical guideline and had become standard of care in certain institutions abroad.

Beside the state-of-the-art near infrared imaging technology, the utilization of minimally invasive technique (both Robotic surgery and Laparoscopic surgery, including 3D Laparoscopy) had revolutionize the standard management of endometrial cancer in HSAAS UPM. Benefits of these “key-hole” surgical methods include faster recovery shorter hospital stay, lesser surgical complications, better patients satisfaction and it can overcome challenges in the surgical management especially for obese and older patients.

Tarikh Input: 16/01/2024 | Kemaskini: 16/01/2024 | khairun