Methods of using optical agents
In certain aspects, the invention relates to processes for using renally excretable optical agents to detect one or more tissues of the renal system of a surgical patient. In certain aspects, the invention relates to a kit including a biocompatible composition containing one or more optical agents and instructions for using the optical agent(s) in a process of the present invention.
1. A process for using a fluorescent agent in a surgical procedure, the process comprising:
administering a renally excretable fluorescent agent into the bloodstream of a patient, wherein the renally excretable optical agent is selected from the group consisting of phenylxanthenes, phenothiazines, phenoselenazines, cyanines, indocyanines, squaraines, dipyrrolo pyrimidones, anthraquinones, tetracenes, quinolines, pyrazines, acridines, acridones, phenanthridines, azo dyes, rhodamines, phenoxazines, azulenes, azaazulenes, triphenyl methane dyes, indoles, benzoindoles, indocarbocyanines, benzoindocarbocyanines, derivatives having the general structure of 4,4-difluoro-4-bora-3a,4a-diaza-s-indacene, and conjugates thereof and derivatives thereof;
irradiating a ureter of the patient's renal system with infrared radiation, visible radiation, ultraviolet radiation or combinations thereof to excite the agent in the patient's urine and cause the agent to fluoresce; and
detecting the agent's fluorescence in the irradiated ureter to demarcate the position of the ureter and distinguish the ureter from the surrounding tissue during the surgical procedure, wherein the surgical procedure is selected from an abdominal surgery and a pelvic surgery.
2. A process for using a fluorescent agent in a surgical procedure, the process comprising:
irradiating a surgical field of a patient undergoing an abdominal surgery with infrared radiation, visible radiation, ultraviolet radiation or combinations thereof to excite a renally excretable fluorescent agent in the patient's urine and cause the agent to fluoresce, which is located in a ureter of the patient's renal system in the surgical field during the irradiating, wherein the renally excretable optical agent is selected from the group consisting of phenylxanthenes, phenothiazines, phenoselenazines, cyanines, indocyanines, squaraines, dipyrrolo pyrimidones, anthraquinones, tetracenes, quinolines, pyrazines, acridines, acridones, phenanthridines, azo dyes, rhodamines, phenoxazines, azulenes, azaazulenes, triphenyl methane dyes, indoles, benzoindoles, indocarbocyanines, benzoindocarbocyanines, derivatives having the general structure of 4,4-difluoro-4-bora-3a,4a-diaza-s-indacene, and conjugates thereof and derivatives thereof; and
surgically manipulating a tissue of the patient based, at least in part, on optical detection of the agent's fluorescence in the ureter and distinguishing the ureter from the surrounding tissue during the abdominal surgery.
3. A process for using a fluorescent agent in a surgical procedure, the process comprising:
administering a renally excretable fluorescent agent into the bloodstream of a patient, wherein the renally excretable optical agent is selected from the group consisting of phenylxanthenes, phenothiazines, phenoselenazines, cyanines, indocyanines, squaraines, dipyrrolo pyrimidónes, anthraquinones, tetracenes, quinolines, pyrazines, acridines, acridones, phenanthridines, azo dyes, rhodamines, phenoxazines, azulenes, azaazulenes, triphenyl methane dyes, indoles, benzoindoles, indocarbocyanines, benzoindocarbocyanines, derivatives having the general structure of 4,4-difluoro-4-bora-3a,4a-diaza-s-indacene, and conjugates thereof and derivatives thereof;
irradiating a ureter of the patient with infrared radiation, visible radiation, ultraviolet radiation or combinations thereof to excite the agent and cause the agent to fluoresce;
subsequent to the administering, detecting the agent's fluorescence based, at least in part, on the irradiating; and
determining if the agent is retained in the urine within the ureter based, at least in part, on the detecting fluorescence.
4. The process of claim 1 , wherein the renally excretable optical agent is selected from fluorescein, and 3,6-diaminopyrazine-2,5-dicarboxylic acid.
5. The process of claim 1 , wherein the renally excretable optical agent is administered intravenously.
6. The process of claim 1 , wherein the agent is detected using at least one of unaided eye, camera, charged coupled device, photomultiplier tube, avalanche diode, and photodiodes.
7. The process of claim 1 , wherein the surgical procedure is selected from total or partial hysterectomy, oophorectomy, tubal ligation, surgical removal of ovarian cysts, anterior repair of the vaginal wall, caesarean section, repair of a pelvic prolapse, pelvic mass resection, removal of a fallopian tube, adnexectomy, removal of an ectopic pregnancy, vasectomy, prostatectomy, hernia repair surgery, colectomy, cholecystectomy, appendectomy, hepatobiliary surgery, splenectomy, distal or total pancreatectomy, the Whipple procedure, and abdominal or pelvic lymphadenectomy.