Indocyanine Green

CMR Surgical's vLimeLite system will first be installed at Gloucestershire Royal Hospitals NHS Trust in the U.K. for use in upper gastrointestinal surgery procedures. CMR Surgical is launching a new imaging technology to help users of its Versius robot visualize the flow of blood through organs during a procedure. The company’s vLimeLite add-on incorporates a near-infrared fluorescent light that reacts with the injectable medical dye indocyanine green, known as ICG. The CE-marked system aims to highlight blood vessels and tissue perfusion beyond the naked eye, as well as the body’s bile duct anatomy. “This is the most significant update of Versius since it launched back in 2019,” CEO Supratim Bose said in the company’s announcement. “We have listened to the needs of surgeons, and I’m delighted that we have been able to give them what they want—a best-in-class ICG product that we know will make a real difference for their patients.” The system will first be installed at Gloucestershire Royal Hospitals NHS Trust in the U.K. for use in upper gastrointestinal surgery procedures. CMR said it plans to roll out vLimeLite first in the U.K., Ireland and Hong Kong before obtaining additional regulatory approvals and expanding globally over the course of this year. vLimeLite will launch with video overlays that integrate with Versius’ 3D vision and will allow the surgeon to toggle between green, cyan and grayscale ICG viewing modes. “I think what is really special is the overlay mode option, which means Versius surgeons will be able to use our integrated ICG system while continuing to view in full color with the same video quality,” said Mark Slack, CMR co-founder and chief medical officer. “vLimeLite truly allows surgeons to see what was once invisible to them.” In January, CMR reported what it described as its strongest quarter on record, in terms of system placements and procedures performed. Over the course of the full 12 months of 2023, the company said its install base grew 50% over 2022’s tally, with surgery counts growing more than 60% to a total of more than 17,000 since Versius’ launch. The numbers follow expansions in Europe, Asia, the Middle East, Africa and Latin America. The company also said it plans to launch new instrumentation options and digital software for Versius in 2024. Late last year, CMR opened a new manufacturing facility near its home in Cambridge, U.K., that it says has the capacity to produce up to 500 Versius systems per year.

Calcium ions are essential for cells, but can be toxic in higher concentrations. A team of researchers has now designed and prepared a combination drug that kills tumor cells by modulating the calcium influx into the cell. An external calcium source is not necessary because only the calcium ions already present in the tumor tissue are used, according to a new study. Calcium ions are essential for cells, but can be toxic in higher concentrations. A team of researchers has now designed and prepared a combination drug that kills tumor cells by modulating the calcium influx into the cell. An external calcium source is not necessary because only the calcium ions already present in the tumor tissue are used, according to the study published in the journal Angewandte Chemie. Biological cells need calcium ions, among other things, for the proper functioning of the mitochondria, the powerhouses of the cells. However, if there is too much calcium, the mitochondrial processes become unbalanced and the cell suffocates. A research group led by Juyoung Yoon of Ewha Womens University in Seoul, South Korea, together with teams from China, has now taken advantage of this process and developed a synergistic antitumor drug that can open calcium channels and thus trigger a deadly calcium storm inside the tumor cell. The researchers targeted two channels, the first one in the outer membrane, and the other was a calcium channel in the endoplasmic reticulum, a cell organelle that also stores calcium ions. The channel located in the outer membrane opens when it is exposed to a large amount of reactive oxygen species (ROS), while the channel in the endoplasmic reticulum is activated by nitric oxide molecules. To generate the ROS that open the outer membrane calcium channel, the researchers used the dye indocyanine green. This bioactive agent can be activated by irradiation with near-infrared light, which not only triggers reactions that lead to ROS, but it also heats up the environment. The team explains that the high local temperature activates the other active agent, BNN-6, to release nitric oxide molecules that open the channel in the endoplasmic reticulum. Following successful trials in tumor cell lines, the team tested an injectable formulation in tumor-implanted mice. To create a biocompatible combined drug, the researchers loaded the active ingredients into tiny modified porous silica beads that are not harmful to the body, but can be recognized by tumor cells and transported into the cell. After injecting the beads into the bloodstream of the mice, the researchers observed that the drug accumulated in the tumor. Exposure to near-infrared light successfully triggered the mechanism of action, and the tumor disappeared after a few days in mice that received the preparation. The authors emphasize that this ion influx approach may also be useful in related biomedical research areas where a similar mechanism could activate ion channels different from calcium in order to find new therapeutic approaches.