Firefly Lights Up Lymph Nodes


HACKENSACK, N.J. (Ivanhoe Newswire)— As many as 65,000 women will be diagnosed this year with endometrial cancer, cancer that develops in the lining of the uterus. Now, a new technique during surgery, known as Firefly, is helping women recover with fewer complications., lymph nodes.

Susan Vander Ploeg was a professional graphic artist early in her career. These days, painting is a good form of stress relief.

“I had been post-menopausal for about seven years and suddenly had some bleeding and I thought this is not good,” Susan Vander Ploeg told Ivanhoe.

Ami Vaidya, MD, a gynecologic oncologist at Hackensack Meridian Health System diagnosed Susan with cancer in her uterine lining. The cancer was early stage, but doctors needed to surgically remove it and ensure it hadn’t metastasized.

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“What we do is we want to identify lymph nodes that are the most likely nodes to be involved if cancer were to spread and leave the uterus,”  said Dr. Vaidya.

At the start of surgery, Dr. Vaidya injected a special dye into Susan’s uterus that was designed to flow into the lymph nodes, it’s nicknamed Firefly. Doctors used a robotic system to perform a hysterectomy then…

“During surgery, we activate a special camera on our robotic lens, and we are able to see in the near infrared spectrum,” Dr. Vaidya noted.

In the infrared mode, the sentinel lymph nodes appear fluorescent green.

Dr. Vaidya explained, “For Susan, we identified lymph nodes on the left and on the right side, they glowed just the way that they’re supposed to. And it allowed us to be so precise in removing them.”

Doctors say by carefully removing the sentinel lymph nodes in the pelvis, patients like Susan have a lower risk of complications like lymphedema.

“I am one of the very lucky ones. And for that, I’m so grateful,” Susan Vander Ploeg exclaimed.

Adding color to a surgical procedure so patients can get back to what matters.

Susan’s scans are clear of cancer and there’s no sign of lymphedema. Doctors say lymphedema can start a few days or a few years after lymph nodes are removed or damaged. With lymphedema, fluid builds up and patients sometimes need additional surgeries.

Contributors to this news report include: Cyndy McGrath, Producer; Kirk Manson, Videographer; Roque Correa, Editor.

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REPORT:       MB #4942

BACKGROUND: Endometrial cancer represents the most common or most prevalent gynecologic malignancy in the United States. It occurs in the inner lining of the uterus. Cells in the inner lining of the uterus transform and become cancerous, and those cancer cells can affect not just the reproductive organs but, if not identified early, can spread to other parts of the body. Endometrial cancer is often detected at an early stage because it frequently produces abnormal vaginal bleeding. If endometrial cancer is discovered early, removing the uterus surgically often cures endometrial cancer.


SYMPTOMS: About 90% of women with endometrial cancer have abnormal vaginal bleeding. This might be a change in their periods, bleeding between periods, or bleeding after menopause. Non-cancer problems can also cause abnormal bleeding. It’s important to have a doctor check out any irregular bleeding right away. After going through menopause, it’s especially important to report any vaginal bleeding, spotting, or abnormal discharge to your doctor. Pain in the pelvis, feeling a mass and losing weight without trying can also be symptoms of endometrial cancer. These symptoms are more common in later stages of the disease.


NEW TECHNOLOGY:  A near-infrared imaging system called Firefly is used to assess sentinel lymph nodes and improve quality of life for patients after endometrial cancer surgery. At the beginning of the surgery, the surgeon injects a fluorescent dye called ICG into the patient’s cervix and uterus. The dye is taken up by the patient’s lymphatic channels and makes its way into the sentinel lymph nodes. Hackensack University Medical Center’s da Vinci robotic surgical systems are specially equipped with near-infrared technology that triggers the injected dye to fluoresce. When the surgeon switches the da Vinci surgical system’s camera to “Firefly mode” from the surgical console, the sentinel lymph nodes appear green — making them easier to see and accurately remove.






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Doctor Q and A

Read the entire Doctor Q&A for Ami Vaidya, MD, Gynecologic Oncologist

Read the entire Q&A