“SPY” Imaging system for flap surgery

With a name like the SPY system, you might think that “Q”, from the James Bond series, would be introducing the technology with a clipped “Pay attention, 007”.

Not the case here, though. Despite the neat moniker, the SPY system is a Canadian-made tool to help surgeons figure out whether tissue is getting the correct amount of blood flow. Using a new twist on a time-honored idea, the system uses a laser to make an intravenous dye called ICG light up, combined with a fancy scanner to enhance the images (shown above) for easy use. In real time, the surgeon can actually watch the dye flow into the flap in the artery, light up the tissue, and return back in the vein, so he/she can feel confident about the condition of the flap. The scanner is a small, mobile unit, perfect for use in the OR or the ICU, which is a big improvement over the clunky, X-ray based angiogram equipment of the past.

In plastic surgery, this gadget comes in very handy for assessing whether microsurgical or pedicle flaps, such as those used in breast reconstruction, are working properly. Clinical testing, done largely here in Florida at the Cleveland Clinic, has shown that the SPY system really gives the surgeon an accurate way to assess the blood flow, with a 95% correlation between imaging and the patient’s clinical course.

Impression: Cool stuff that works! Breast reconstruction surgeons should check this out.


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