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EMEA ICG Dosing for Lower Limb Lymphedema

  • Intro:

    Indocyanine green (ICG) fluorescence imaging is widely used in lower limb lymphedema to visualize lymphatic flow and assess the severity of lymphatic dysfunction. This technique enables real-time mapping of superficial lymphatic vessels, supporting accurate diagnosis, staging, and surgical planning.

    ICG lymphangiography has demonstrated high sensitivity and specificity compared to conventional imaging, allowing precise identification of functional lymphatic channels and guiding procedures such as lymphaticovenular anastomosis.

    In the EMEA region, standardized dosing and timing protocols help ensure consistent fluorescence imaging and improve intraoperative decision-making in the management of lower limb lymphedema.

  • Sección:
    • Tabla:
      • Columna1:

        Region of interest

        , Contenido:

        Lymphatic vessels

      • Columna1:

        Dose

        , Contenido:

        0.05–0.1 mL (0.125-0.25 mg/mL)

      • Columna1:

        Route

        , Contenido:

        Intra-dermal

      • Columna1:

        Injection time

        , Contenido:

        Beginning of assessment

      • Columna1:

        First ICG detection

        , Contenido:

        Beginning of assessment

      • Columna1:

        ICG Duration

        , Contenido:

        Lymph flow tracked for 1 hr

      • Columna1:

        Camera requirements

        , Contenido:

        NIR light source camera

      • Columna1:

        References  (full ref details at end of this guide doc)

        , Contenido:

        17. 2022, Suami et al.,

EMEA ICG Dosing for Thyroidectomy

  • Intro:

    Indocyanine green (ICG) fluorescence imaging is used in thyroidectomy to identify and assess the perfusion of parathyroid glands, helping to preserve their function during surgery. Real-time visualization of vascularization supports intraoperative decision-making and reduces the risk of postoperative complications such as hypocalcemia and hypoparathyroidism.

    In the EMEA region, standardized dosing and timing protocols aim to improve consistency in fluorescence imaging and enhance surgical safety by optimizing parathyroid preservation.

  • Sección:
    • Tabla:
      • Columna1:

        Region of interest

        , Contenido:

        Parathyroid glands preservation - anatomy of feeder vessels to Parathyroid glands

      • Columna1:

        Dose

        , Contenido:

        0.1mg/kg

      • Columna1:

        Route

        , Contenido:

        I.V.*

      • Columna1:

        Injection time

        , Contenido:

        Intraoperatively

      • Columna1:

        First ICG detection

        , Contenido:

        60 – 120 sec

      • Columna1:

        ICG Duration

        , Contenido:

        3-4 min

      • Columna1:

        Camera requirements

        , Contenido:

        NIR light source camera

      • Columna1:

        References  (full ref details at end of this guide doc)

        , Contenido:

        6. 2017, Sadowski et al.,

ICG Dosing and Timing for Thyroidectomy

  • Intro:

    Indocyanine green (ICG) fluorescence imaging is increasingly used during thyroidectomy to help identify and preserve parathyroid glands and assess tissue perfusion. Using near-infrared fluorescence imaging, surgeons can visualize parathyroid vascularization in real time, supporting safer thyroid surgery and reducing the risk of postoperative hypoparathyroidism.

    This dosing and timing chart provides guidance on recommended ICG administration for thyroidectomy procedures, including intravenous injection protocols, dosage considerations, and expected fluorescence detection timing to optimize fluorescence imaging during thyroid surgery.

  • Sección:
    • Title: Dosing & Timing Chart, Tabla:
      • Columna1:

        Purpose:

        , Contenido:

        Visualization of parathyroid glands

      • 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:

        1 mL

      • Columna1:

        Injection Time: 

        , Contenido:

        After thyroid gland dissection

      • 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:

        Handheld

      • Columna1:

        Tips & Tricks: 

        , Contenido:

        Check perfusion of parathyroid glands at the time of assessment.

    • Title: Dosing & Timing Chart, Contenido: , Tabla:
      • Columna1:

        Purpose: 

        , Contenido:

        Guided dissection during thyroid gland exposure

      • 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:

        1 mL

      • Columna1:

        Injection Time: 

        , Contenido:

        During thyroid gland dissection

      • 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:

        Handheld

      • Columna1:

        Tips & Tricks: 

        , Contenido:

        Check vasculature surrounding gland during superior pole dissection

Use of Fluorescent techniques in Endocrine and Small Bowel Surgery

  • Thumbnail 512x288:
  • Congreso: ACS Boston 2023
  • Título del video: Use of Fluorescent techniques in Endocrine and Small Bowel Surgery - Discussion
  • Speakers: Raúl Rosenthal, Fernando Dip, Michael Bouvet
  • Youtube/Vimeo link: https://vimeo.com/880687646?share=copy
  • Date: 2023-10-24
Use of Fluorescent techniques in Endocrine and Small Bowel Surgery - Discussion Raúl Rosenthal, MDFernando Dip, MDMichael Bouvet, MD ACS Boston 2023

Consensus in Endocrine Surgery

  • Thumbnail 512x288:
  • Título del video: Consensus in Endocrine Surgery
  • Speakers: Michael Bouvet and Fernando Dip
  • Descripción: In 2019, The International Society for Fluorescence Guided Surgery hosted a series of Delphi surveys meant to standardize the use of ICG in various specialties. During this webinar, Dr. Michael Bouvet and Dr. Fernando Dip discuss ICG and fluorescence as related to endocrine surgery.
  • Youtube/Vimeo link: https://www.youtube.com/watch?v=XRz6QqhPt1w&rco=1
  • Date: 2019-06-25
Consensus in Endocrine Surgery Michael Bouvet and Fernando Dip In 2019, The International Society for Fluorescence Guided Surgery hosted a series of Delphi surveys meant to standardize the use of ICG in various specialties. During this webinar, Dr. Michael Bouvet and Dr. Fernando Dip discuss ICG and fluorescence as related to endocrine surgery. 25-06-2019