Certain surgeries, such as those targeting the pelvic region—like colorectal cancer surgeries and gynecological procedures—pose a significant risk to pelvic nerves, leading to complications like sexual dysfunction and urinary or fecal incontinence. Similarly, cranial nerve damage during head and neck procedures can cause difficulties with swallowing, changes in voice, or facial paralysis.
Despite ongoing efforts to develop new nerve-targeting agents for minimally invasive surgeries, none have yet received regulatory approval. Current intraoperative monitoring tools, such as electromyographic nerve monitoring, only provide feedback after nerve contact or damage has occurred and cannot identify sensory nerves.
In a groundbreaking study, an interdisciplinary team led by scientists from Stanford University, HelmholtzMunich, its PioneerCampus, UKD and the NCT in Dresden, researchers have introduced a novel application of sodium fluorescein, a clinically approved fluorescent contrast agent, to significantly enhance nerve visualization during surgical procedures. Sodium fluorescein is cost-effective, boasts a well-established safety profile, and has been widely used in ophthalmology. By using clinical imaging systems and administering sodium fluorescein at standard doses, the study demonstrates the ability to visualize nerves with superior contrast compared to traditional visible-light inspection methods. Remarkably, this approach enables the identification of nerves even when they are obscured by surrounding fatty or fibrous tissue.
Given that both sodium fluorescein and the imaging devices are already approved for clinical use, this innovative approach allows for rapid and widespread adoption, potentially reducing unintended nerve damage and therefore transforming current surgical practices. This novel method represents a significant advancement with immediate application potential and impact for a variety of surgical procedures, hence offering great hope for rapid improvements of patient outcomes.