吲哚菁绿实时荧光显像技术在机器人结直肠癌手术中的应用与展望

The Application and Prospects of Indocyanine Green Real-Time Fluorescence Imaging Technology in Robotic Colorectal Cancer Surgery

摘要: 结直肠癌作为全球高发的恶性肿瘤之一，其手术治疗的精准性直接影响患者预后。机器人手术系统凭借灵活的机械臂、高清三维显像及震颤过滤等优势，已成为结直肠癌根治术的重要平台，但其在触觉反馈，肿瘤及淋巴结精准定位、血供评估等方面仍存在局限。吲哚菁绿(Indocyanine Green, ICG)实时荧光显像技术通过提供术中可视化导航，在淋巴结示踪、血流灌注评估、肿瘤定位及神经与输尿管保护等方面展现出显著的视觉增强优势。近年来，多项临床研究探索了ICG在机器人结直肠癌手术中的应用，但在远期获益及标准化操作方面仍存争议。本文系统综述了ICG显像的基本原理及其在机器人结直肠癌手术中的应用现状，分析其优势与局限性，并探讨未来新型荧光剂型、自动化量化评估预警及多学科融合的发展方向，以期为临床规范化应用提供参考。

Abstract: Colorectal cancer, as one of the globally prevalent malignant tumors, has its surgical treatment precision directly impacting patient prognosis. Robotic surgical systems, with advantages such as flexible robotic arms, high-definition three-dimensional imaging, and tremor filtering, have become an important platform for radical resection of colorectal cancer. However, they still have limitations in areas such as tactile feedback, precise localization of tumors and lymph nodes, and blood supply assessment. Indocyanine green (ICG) real-time fluorescence imaging technology, by providing intraoperative visual navigation, demonstrates significant visual enhancement advantages in lymph node tracing, blood flow perfusion assessment, tumor localization, and protection of nerves and ureters. In recent years, multiple clinical studies have explored the application of ICG in robotic colorectal cancer surgery, but controversies remain regarding long-term benefits and standardized procedures. This article systematically reviews the fundamental principles of ICG imaging and its current applications in robotic colorectal cancer surgery, analyzing its advantages and limitations, and discusses future development directions, including novel fluorescent agent formulations, automated quantitative assessment and early warning, and multidisciplinary integration, aiming to provide references for standardized clinical application.