Indocyanine green (ICG) fluorescence imaging is increasingly used in colorectal and gastrointestinal cancer surgery to visualize lymphatic drainage and identify sentinel lymph nodes. When combined with near-infrared imaging systems, ICG enables real-time mapping of lymphatic pathways and supports more precise oncologic surgery.
This dosing chart outlines recommended ICG administration for colorectal and gastrointestinal carcinoma procedures, including peritumoral injection techniques, dosage per tumor quadrant, and timing of administration. These parameters help optimize sentinel lymph node detection and lymphatic mapping during fluorescence-guided surgery.
Dilution (25 mg in 10 mL of sterile water - 2.5mg/mL):
, Contenido:
Yes
Columna1:
Requires Flush with Sterile Water:
, Contenido:
No
Columna1:
Proposed Dosage:
, Contenido:
1 mL
Columna1:
Injection Time:
, Contenido:
Intraoperatively
Columna1:
First Indocyanine Green Detection:
, Contenido:
Minutes after administration
Columna1:
Indocyanine Green Duration:
, Contenido:
Stable during surgery. Slowly diffuses through lymphatics
Columna1:
Camera Requirements (handheld device, laparoscope or both):
, Contenido:
Both
Columna1:
Tips & Tricks:
, Contenido:
Intramural tumor: Intraoperative administration avoiding too much depth into the mucosa. Gastric lymphatics mapping: consider endoscopic peritumoral dye administration 24 hrs prior to lymphadenectomy.
Indocyanine green (ICG) fluorescence imaging is widely used in colorectal surgery to assess tissue perfusion and support safe intestinal dissection and anastomosis. By using near-infrared fluorescence imaging, surgeons can visualize real-time blood flow to the bowel and evaluate vascularization before performing colorectal anastomosis.
This dosing and timing chart provides guidance on recommended ICG administration for colorectal dissection procedures, including intravenous injection protocols, dosage ranges, and expected fluorescence detection times. These parameters help optimize intraoperative perfusion assessment and improve surgical decision-making during fluorescence-guided colorectal surgery.
Sección:
Title: Dosing & Timing Chart, Tabla:
Columna1:
Purpose:
, Contenido:
Perfusion assessment
Columna1:
Injection Type:
, Contenido:
Intravenous
Columna1:
Dilution (25 mg in 10 mL of sterile water - 2.5mg/mL):
, Contenido:
Yes
Columna1:
Requires Flush with Sterile Water:
, Contenido:
Yes
Columna1:
Proposed Dosage:
, Contenido:
3 mL
Columna1:
Injection Time:
, Contenido:
Intraoperatively
Columna1:
First Indocyanine Green Detection:
, Contenido:
30–60 seconds after administration
Columna1:
Indocyanine Green Duration:
, Contenido:
60 seconds–3 minutes
Columna1:
Camera Requirements (handheld device, laparoscope or both):
, Contenido:
Both
Columna1:
Tips & Tricks:
, Contenido:
Perform tissue vitality assessment as necessary prior to resection. Repeat assessment after anastomosis.
Indocyanine green (ICG) fluorescence imaging is increasingly used during abdominal and pelvic surgery to assist in ureter localization and help prevent inadvertent ureteral injury. With near-infrared fluorescence imaging, surgeons can visualize ureteral pathways in real time, improving anatomical identification during complex surgical procedures.
This dosing and timing chart provides guidance on recommended ICG administration techniques for ureter localization, including injection methods, dosage considerations, and expected fluorescence detection timing to support safe and effective fluorescence-guided surgery.
Sección:
Title: Dosing & Timing Chart, Tabla:
Columna1:
Purpose:
, Contenido:
Visualization of ureters
Columna1:
Injection Type:
, Contenido:
Other
Columna1:
Description:
, Contenido:
Cystoscopy guidance is recommended for retrograde intraureteral dye administration
Columna1:
Dilution (25 mg in 10 mL of sterile water - 2.5mg/mL):
, Contenido:
Yes
Columna1:
Requires Flush with Sterile Water:
, Contenido:
No
Columna1:
Proposed Dosage:
, Contenido:
5 mL per ureter
Columna1:
Injection Time:
, Contenido:
Prior to pelvic dissection
Columna1:
First Indocyanine Green Detection:
, Contenido:
During pelvic dissecction
Columna1:
Indocyanine Green Duration:
, Contenido:
Remains stable during surgery
Columna1:
Camera Requirements (handheld device, laparoscope or both):
, Contenido:
Both
Columna1:
Tips & Tricks:
, Contenido:
Advance ureteral catheter to ensure comprehensive assessment of the ureteral course
New Frontiers in Colorectal Surgery using Fluorescence-Guided Techniques | Discussion
Sonia L. Ramamoorthy, MDSteven D. Wexner, MDMarylise Boutros , MD
