Indocyanine green (ICG) fluorescence imaging is used in laparoscopic sleeve gastrectomy to evaluate gastric perfusion and support intraoperative decision-making. By providing real-time visualization of blood supply, this technique helps surgeons identify critical vascular structures and optimize staple line integrity.
In the EMEA region, standardized dosing and timing protocols aim to improve consistency in fluorescence imaging and enhance surgical safety. Although its routine use in bariatric surgery remains under evaluation, ICG has shown potential in assessing tissue perfusion and reducing ischemic complications.
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Tabla:
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Region of interest
, Contenido:
Proximal stomach
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Dose
, Contenido:
5 -15 mg bolus
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Route
, Contenido:
I.V.*
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Injection time
, Contenido:
Intraoperatively
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First ICG detection
, Contenido:
30-60 sec
Columna1:
ICG Duration
, Contenido:
3-4 min
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Camera requirements
, Contenido:
Laparoscope, NIR light source camera
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References (full ref details at end of this guide doc)
Indocyanine green (ICG) fluorescence imaging is increasingly used in oesophagectomy to assess gastric conduit perfusion and guide anastomotic site selection. Adequate vascularization is critical, as poor perfusion is a major factor in anastomotic leak, one of the most serious postoperative complications.
In the EMEA region, standardized dosing and timing protocols help ensure consistent fluorescence imaging, supporting intraoperative decision-making and potentially reducing perfusion-related complications.
Sección:
Tabla:
Columna1:
Region of interest
, Contenido:
Gastric conduit
Columna1:
Dose
, Contenido:
5 mg bolus
Columna1:
Route
, Contenido:
I.V.*
Columna1:
Injection time
, Contenido:
Intraoperatively
Columna1:
First ICG detection
, Contenido:
60 – 100 sec
Columna1:
ICG Duration
, Contenido:
3-4 min
Columna1:
Camera requirements
, Contenido:
Laparoscope, NIR light source camera
Columna1:
References (full ref details at end of this guide doc)
Indocyanine green (ICG) fluorescence imaging is increasingly used during esophagectomy to assess gastric conduit perfusion and support safe esophagogastric anastomosis. Near-infrared fluorescence angiography allows surgeons to visualize real-time blood flow to the gastric conduit, helping identify well-perfused tissue and reduce the risk of anastomotic complications.
This dosing and timing chart outlines recommended ICG administration for esophagectomy procedures, including intravenous injection protocols, dosage guidance, and expected fluorescence detection times to optimize intraoperative perfusion assessment during fluorescence-guided surgery.
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Title: Dosing & Timing Chart, Tabla:
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Purpose:
, Contenido:
Perfusion assessment
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Injection Type:
, Contenido:
Intravenous
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Dilution (25 mg in 10 mL of sterile water - 2.5mg/mL):
, Contenido:
Yes
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Requires Flush with Sterile Water:
, Contenido:
Yes
Columna1:
Proposed Dosage:
, Contenido:
3 mL
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Injection Time:
, Contenido:
Intraoperatively
Columna1:
First Indocyanine Green Detection:
, Contenido:
30–60 seconds after administration
Columna1:
Indocyanine Green Duration:
, Contenido:
60 seconds–3 minutes
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Camera Requirements (handheld device, laparoscope or both):
, Contenido:
Both
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Tips & Tricks:
, Contenido:
Perform tissue vitality assessment, as necessary, prior to resection. Repeat assessment after anastomosis.
Sven Mieog, Leiden University Medical Center, Leiden, NL
Karol Polom, Wielkopolska Cancer Center Poznań, Poznań, PL
Alexander Vahrmeijer, Leiden University Medical Center, Leiden, NL
Luigi Boni, IRCCS – Ca’ Granda, Policlinico Hospital of Milan, Milan, IT
During this course participants will obtain a thorough knowledge of the fundamentals and state-of-the-art applications of fluorescence imaging of tumours (primary, metastases, lymph nodes), sentinel lymph nodes and lymphatics, vital structures (bile ducts, ureters, nerves) and perfusion assessment of organs and tissues. Besides traditional fluorescent, fluorescent dyes, participants will discover and work with novel antibody-/peptide-/nanobody-based targeted fluorescence-guided surgical navigation. They will experience the possibilities and limitations of this intra-operative technique also in relation to open, laparoscopic and robotic approaches.
Open to
Oncologic surgeons, gynaecologists, urologists, thoracic surgeons, plastic and reconstructive surgeons, gastro-intestinal surgeons and vascular surgeons, researchers in the field of image-guided-surgery, and those who are in training for these medical specialties with an interest in the fundamentals and ap-plications of fluorescence-guided surgery.
Educational methods
Hands on session testing different fluorophores and fluorescencecontrast agents and their behaviour in different situations withvarious commercially available and experimental imaging systems.
Plenary lectures
Main topics
Fluorescence imaging of lymphatics & SLN
Fluorescence imaging of tissue perfusion
Imaging of biliary tract and ureters
Imaging of tumor tissue
Title: ESSO-ISFGS Course on Fluorescence-Guided Surgery
ISFGS Past Events
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Group Picture ESSO Fluorescentie
IMG 0770
Leiden, 6 June
Exciting day 1 of the course at the LUMC!We welcomed 70 participands from 13 countries for the ESSO-ISFGS course. Today was all about present-day usage of fluorescence guided surgery and hands-on learning. We kicked off with an in-depth exploration of fluorescence imaging...
