In this first published survey of international experts on fluorescence-guided surgery, we sought to identify areas of consensus and non- consensus across 4 areas of practice: fundamentals; patient selection/ preparation; technical aspects; and effectiveness and safety.
Abstract Background Colorectal anastomoses in patients with colorectal cancer carry a high risk of leakage. Indocyanine green fluorescence angiography (ICG-FA) is a new technique that allows surgeons to assess the blood perfusion of the anastomosis during operation. This meta-analysis aimed to evaluate whether ICG-FA could prevent anastomotic leakage (AL) in colorectal surgery. Methods Four databases (PubMed, Embase, Web of Science, and Cochrane Library) were searched to identify suitable literatures until March 2020 that compared AL rates between intraoperative use and non-use of ICG-FA in colorectal surgery for cancer. The Review Manager 5.3 software was used to perform the statistical analysis. Evaluation of articles quality and analysis for publication bias were also conducted. Results Thirteen studies of 4037 patients were included in the meta-analysis. The study included 1806 patients in the ICG group and 2231 patients in the control group. The …
Abstract Background Reliable perfusion of the distal portions of free flaps is decisive for the reconstructive success. Indocyanine green near-infrared video angiography (ICG-NIR-VA) has been adopted for objective assessment of free flap tissue perfusion but is thus far not used on a routine basis. Therefore, we investigated its intraoperative impact on decision-making and postoperative outcome. Methods From January 2017 to June 2019, 88 consecutive adipo- or fasciocutaneus free flaps were performed in conjunction with intraoperative ICG-NIR-VA. Free flap tissue perfusion was first assessed clinically and then compared with ICG-NIR-VA findings. Based on the results, the decision for intraoperative trimming of critically perfused flap zones was made. The way of decision-making, flap success, and failure rates as well as intra- and postoperative complication rates were analyzed. Results The overall free flap success rate was 92.0%. Partial flap necrosis occurred in five …
Authors: Lindsay A. White Jason P. Joseph David Y. Yang Scott R. Kelley Kellie L. Mathis Kevin Behm Boyd R. Viers
Anastomotic leak is a life-threatening complication of colorectal surgery. Recent studies showed that indocyanine green fluorescence angiography might be a method to prevent anastomotic leak.
Anastomotic leakage after a colorectal resection results in devastating consequences for patients. Indocyanine green fluorescence angiography is a modality to visualize vascular perfusion at the anastomotic site and can help surgeons decide the viability of the anastomosis. We performed this systematic review and meta-analysis to evaluate the efficacy of indocyanine green fluorescence angiography in decreasing anastomotic leakage.
Bile duct injuries during laparoscopic cholecystectomy remain a potentially devastating complications and are responsible for major 1 morbidity and prolonged hospitalization . Visual misperception, anatomical variations in the extrahepatic biliary tree, combined with inflammatory changes and surgeon inexperience in recognizing the 2 anatomy, are among the most common reasons for these injuries . Near-infrared Incisionless Fluorescent Cholangiography (NIFC) has been shown to improve the visualization and identification of the biliary structures compared to traditional white light.
In spite of many technical advances, esophagectomy remains a morbid procedure. The most dreaded complication is the leakage at the esophagogastric anastomosis, often determined by the tenuous vascular perfusion of the gastric conduit. As in other gastrointestinal anastomosis, assessment of the anastomotic perfusion with fluorescence angiography could decrease this complication. We present a case in which Indocyanine Green (ICG) dye fluorescence was used to assess vascular perfusion for colonic interposition after graft necrosis in a patient with previous esophagectomy.
Abstract Every field of surgery has seen an explosion of new technologies aimed at improving surgical technique and reducing complications. The use of near-infrared (NIR) fluorescence to assess perfusion has been described in several surgical disciplines. NIR provides the surgeon with real-time perfusion assessment of a target organ or anastomosis and can be invaluable in aiding decision-making during the index operation. In the following article we discuss the use of fluorescence-guided perfusion assessment during colonic interposition for esophageal replacement. To our knowledge this is the first description of the use of fluorescence-guided perfusion assessment during colonic interposition. Keywords: ICG; colonic interposition; esophagus; fluorescence-guided surgery; near infrared.
Authors: Shiksha JoshiEmanuele Lo MenzoFernando DipSamuel SzomsteinRaul J. Rosenthal