Our publications library is focused on collecting all of the most up-to-date research and information in the field of fluorescence guided surgery. We hope you find it to be a valuable resource!
In February 2019 in Frankfurt, Germany, the Advisory Board of the International Society of Fluorescence-Guided Surgery (ISFGS) unanimously voted to conduct a series of Delphi surveys across multiple surgical fields as a first step towards drafting consensus guidelines. The first of these surveys, on its general use, has already been published in Annals of Surgery in April…
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Abstract Background Nerve visualization and the identification of other neural tissues during surgery is crucial for numerous reasons, including the prevention of iatrogenic nerve and neural structure injury and facilitation of nerve repair. However, current methods of intra-operative nerve detection are generally expensive, unproven, and/or technically challenging. Recently, we have documented, in both in vivo…
Read moreAbstract Background The application of indocyanine green fluorescence–guided hepatectomy for liver metastases from colorectal cancer is in the preliminary stage of clinical practice; thus, its efficacy needs to be determined. This study compared the number of intrahepatic colorectal liver metastases detected intraoperatively and postoperative recovery data between patients who underwent traditional hepatectomy (nonindocyanine green group)…
Read moreAbstract Background Fluorescence angiography (FA) using indocyanine green dye (ICG) has recently been introduced for real-time identification of parathyroid adenomas. However, time to peak fluorescence has not yet been critically evaluated. Methods This was a retrospective review of parathyroidectomies with ICG FA over a one-year period. Results There were 66 patients with average age of…
Read moreAbstract Background Intrahepatic cholangiocarcinoma is a highly lethal malignancy characterized by lymph node metastasis. This study aimed to evaluate the efficacy of indocyanine green fluorescence for visualization of lymphatic drainage and to assess its clinical application during laparoscopic lymph node dissection for intrahepatic cholangiocarcinoma. Methods All patients with intrahepatic cholangiocarcinoma who underwent laparoscopic left hepatectomy…
Read moreAbstract Objectives Intraoperative fluorescence imaging is currently used in a variety of surgical fields for four main purposes: assessing tissue perfusion; identifying/localizing cancer; mapping lymphatic systems; and visualizing anatomy. To establish evidence-based guidance for research and practice, understanding the state of research on fluorescence imaging in different surgical fields is needed. We evaluated the evidence…
Read moreAbstract Purpose Indocyanine green (ICG) and sodium fluorescein (SF) are fluorescent dyes used for sentinel lymph node mapping. In oncological gastric surgery, ICG lymphography has increased the number of resected lymph nodes. However, the optimal time to administer ICG is unclear, and both preoperative and intraoperative injections have been practised. As dye spillage will diminish…
Read moreAbstract Background Recently, we reported the feasibility of indocyanine green (ICG) near-infrared fluorescence (NIRF) imaging to identify extrahepatic biliary anatomy during laparoscopic cholecystectomy (LC) in pediatric patients. This paper aimed to describe the use of a new technology, RUBINA™, to perform intra-operative ICG fluorescent cholangiography (FC) in pediatric LC. Methods During the last year, ICG-FC…
Read moreAbstract Although less common than other types of skin cancers, melanoma is accountable for the majority of skin cancer-related deaths. The standard management for patients with clinically negative nodes includes a sentinel lymph node (SLN) biopsy, which is commonly performed using a combination of radioactive tracer (Tc-99) and a blue dye (isosulfan or patent blue).…
Read moreStephanie L. Koonce*, Martin I. Newman University of Minnesota Medical School, USA *Corresponding author: Stephanie L. Koonce, University of Minnesota Medical School, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd., Weston, USA Published: 23 Jun, 2017 Cite this article as: Koonce SL, Newman MI. A Systematic Review of Concordance between Indocyanine Green and 99m Technetium Sentinel Lymph Node Identification…
Read moreAbstract Background This study aimed to standardize the operative technique of indocyanine green (ICG) near-infrared fluorescence (NIRF) laparoscopic partial nephrectomy (LPN) and compare it with the standard technique. Methods In the last 4 years, we performed 22 LPN (14 right-sided, 8 left-sided) in children with non-functioning moiety of duplex kidney. Patients included 12 girls and…
Read moreAbstract Background Anastomotic leakage (AL) after gastrointestinal resection is a devastating complication with huge consequences for the patient. As AL is associated with poor blood supply, tools for objective assessment of perfusion are in high demand. Indocyanine green angiography (ICG-FA) and quantitative analysis of ICG-FA (q-ICG) seem promising. This study aimed to investigate whether ICG-FA…
Read moreMethods: Samples from various human peripheral nerves were selected postoperatively. Nerve fibers were divided into three groups: Group A nerve fibers were washed with a physiologic solution; Group B nerve fibers were fixated with formaldehyde for 6 h first, and then washed with a physiologic solution; Group C nerve fibers were fixated with formaldehyde for six…
Read moreMethods: We exposed sciatic nerves within the posterior thigh in five 250-300 gm Wistar rats, then observed them at four different NUV intensity levels: 20%, 35%, 50%, and 100%. Brightness of fluorescence was measured by fluorescence spectroscopy, quantified as a fluorescence score using Image-J software, and statistically compared between nerves, background, and both an artery and…
Read moreMethods In this descriptive study, we performed microanatomical evaluations and intraoperative imaging analysis in a cadaver and patients with rectal cancer. Specimens with India ink injection were collected from a cadaver and six patients who underwent abdominoperineal resection. Intraoperative indocyanine green fluorescence imaging was performed on four patients who underwent surgery for lower rectal cancer.…
Read moreMethods A thorough PubMed search was conducted to identify randomized clinical trials and nonrandomized clinical trials with ≥100 patients. Because all near-infrared fluorescent cholangiography studies were published since 2013, only studies without near-infrared fluorescent cholangiography published since 2013 were included for comparison. Incidence estimates, weighted and unweighted for study size, were adjusted for acute versus…
Read moreMETHODS Intraoperative white-light and NIR-fluorescence multispectral videos of primary colorectal tumours in patients undergoing diagnostic and therapeutic intervention were used for both AI model training and testing. These contained mucosal tumours subsequently determined as being benign or malignant with their surrounding area of macroscopically normal tissue, as viewed in both white light and NIR after…
Read moreThe authors of this publication are to be commended for conducting this retrospective study analyzing the impact of near infrared fluorescent cholangiography (NIFC) in patients undergoing laparoscopic cholecystectomy (LC) for symptomatic or complicated cholelithiasis in an acute care setting. In this study, a total of 198 patients who underwent LC were evaluated. Acute cholecystitis was…
Read moreBackground: In recent decades, the use of near-infrared light and fluores- cence-guidance during open and laparoscopic surgery has exponentially expanded across various clinical settings. However, tremendous variability exists in how it is performed. Objective: In this first published survey of international experts on fluorescence-guided surgery, we sought to identify areas of consensus and non- consensus across 4…
Read moreABSTRACT 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…
Read moreABSTRACT 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.…
Read moreABSTRACT Aim Up to 10% of patients undergoing non‐urologic abdominopelvic operations suffer a ureteral injury. While preoperative ureteral stenting to facilitate ureteral identification is common, it does not reduce the incidence of intraoperative ureteral injury and is not without risk. As we continue to broaden the application of minimally invasive surgical techniques, a new form…
Read moreABSTRACT BACKGROUND 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. OBJECTIVE The purpose of this study was to investigate whether intraoperative indocyanine green fluorescence angiography can reduce the incidence of anastomotic leak. DATA SOURCES Potential relevant studies were identified from the…
Read moreBackground 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…
Read moreCase Report The following case study discusses a 37 years old, morbidly obese woman (BMI 43 Kg/m2) with impaired fasting glucose and no significant surgical history who presented to the clinic with a 3-month history of right upper quadrant (RUQ) abdominal pain, especially after meals. The physical exam revealed tenderness in the RUQ with a…
Read moreCase Report A 72-year-old Caucasian male with a past medical history of type 2 diabetes mellitus, hypertension, hyperlipidemia, myocardial infarction, gastric ulcer, gastroesophageal reflux disease (GERD), presented to the clinic complaining of lower chest discomfort and progressive dysphagia to both liquid and solid food for approximately four months. At the endoscopy he was found to…
Read moreAbstract 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…
Read moreABSTRACT Laparoscopic cholecystectomy is the surgical treatment of choice for benign diseases of the gallbladder because of the advantage of shorter postoperative hospital stays with faster recovery and cosmetic superiority. However, complications like iatrogenic vascular and bile duct injury are associated with a severe outcome. Most of the intraoperative injuries during use of the laparoscopic…
Read moreABSTRACT Aim Transanal total mesorectal excision is a promising novel sphincter‐saving procedure for low rectal cancer. However, the transanal bottom‐up dissection is associated with increased rates of iatrogenic urethral injuries. Near‐infrared fluorescence (NIRF) imaging, given its deeper tissue penetration, has been explored in a limited number of studies for enhanced intra‐operative urethral visualization. In this…
Read moreReleased: July 14th, 2020 08:25 PM Website: HTTPS://ONLINELIBRARY.WILEY.COM/DOI/FULL/10.1111/CODI.15158
Read moreABSTRACT Introduction Current methods of intraoperative margin assessment in breast conserving surgery are impractical, unreliable, or time consuming. We hypothesized that intraoperative near-infrared (NIR) imaging with an FDA-approved NIR optical contrast agent could identify canine mammary tumors, a spontaneous large animal model of human breast cancer, during surgery. Methods Dogs with mammary tumors underwent a…
Read moreQuestion Can an intraoperative near-infrared fluorescence imaging technique be used to detect lung tumor margin via inhalation delivery of indocyanine green? Findings In this diagnostic study, the fluorescent signal of inhaled indocyanine green was observed throughout healthy lung tissue but was rarely detected in tumor tissue. Inhalation at a 20-fold lower dose of indocyanine green…
Read moreABSTRACT Introduction: The incidence of primary non-function (PNF) after liver transplantation (LT) remains a major concern with the increasing use of marginal grafts. Indocyanine green (ICG) fluorescence is an imaging technique used in hepatobiliary surgery and LT. Because few early predictors are available, we aimed to quantify in real time the fluorescence of grafts during LT…
Read moreWe report the use of indocyanine green (ICG) for ureteral identification during nonurologic surgery. Indocyanine green is a cyanine-based dye that can be injected intravenously to visualize vascularized structures with near-infrared (NIR) fluorescence. Other reports suggest that intraureteral ICG instillation offers benefits for ureteral identification during urologic and nonurologic minimally invasive surgery.1,2 JAMA Surg. Published online…
Read moreMethods A single center randomized trial was undertaken between 2018 and 2019. Those patients who underwent a stapled colorectal anastomosis were randomized 1:1 for ICG FA vs. visual clinical assessment of blood perfusion of the anastomosed colon and rectal stump (non‐ICG FA group). The primary end‐point was to assess whether ICG FA was associated with…
Read moreIntroduction: Surgery is the most important therapy for patients with cancer of the colon, rectum or pancreas. Complete resection, which is a crucial factor in the prognosis of a patient, is challenging as surgeons have to rely on visual appearance and palpation to discriminate between tumor and normal tissue. Carcinoembryonic antigen (CEA) is a tumor-specific…
Read moreABSTRACT Background Anastomotic leakage (AL) is one of the most troublesome complications in colorectal surgery. Recently, near-infrared fluorescence (NIRF) imaging has been used intraoperatively to detect sentinel lymph nodes and visualize the blood supply at the region of interest (ROI). The aim of this study was to evaluate the role of visualization and quantification of…
Read moreFLUORESCENT ANTIBODY SGM-101 A near infrared-emitting fluorochrome-labeled anti-carcinoembryonic antigen (ACE; anti-CEA) monoclonal antibody, with potential diagnostic imaging activity. Upon administration, the fluorescent antibody SGM-101 binds CEA-overexpressing cancer cells. Upon fluorescence imaging, the fluorochrome can be visualized and CEA-overexpressing cancer cell can be imaged and detected. CEA, a tumor-associated antigen (TAA), is overexpressed on the surface…
Read moreAbstract PURPOSE: Fluorescence-guided surgery (FGS) provides surgeons with new opportunities to improve real-time cancer nodule detection and tumor margin visualization. Currently, the most important challenge in this field is the development of fluorescent dyes that specifically target tumors. We developed, characterized and evaluated SGM-101, an innovative antibody-dye conjugate in which the fluorochrome BM104, which has…
Read moreSurgery is the most important therapy for patients with cancer of the colon, rectum or pancreas. Complete resection, which is a crucial factor in the prognosis of a patient, is challenging as surgeons have to rely on visual appearance and palpation to discriminate between tumor and normal tissue. Carcinoembryonic antigen (CEA) is a tumor-specific marker…
Read moreAbstract BACKGROUND: Parathyroid glands are difficult to identify during total thyroidectomies, and accidental resection can lead to problematic postoperative hypocalcemia. Our main goals were to evaluate the effectiveness of using near-infrared light (NIRL) autofluorescence intraoperatively for parathyroid gland identification and to measure its impact on postoperative hypocalcemia incidence. STUDY DESIGN: Total thyroidectomies were performed on…
Read moreAbstract Background: Incisionless near-infrared fluorescent cholangiography (NIFC) is emerging as a promising tool to enhance the visualization of extrahepatic biliary structures during laparoscopic cholecystectomies. Methods: We conducted a single-blind, randomized, 2-arm trial comparing the efficacy of NIFC (n = 321) versus white light (WL) alone (n = 318) during laparoscopic cholecystectomy. Using the KARL STORZ Image1 S imaging system with OPAL1 technology…
Read moreAbstract BACKGROUND: The aim of this study was to evaluate the impact of fluorescence angiography (FA) on any change in proximal resection margin and/or anastomotic leak (AL) following transanal total mesorectal excision (TaTME) for rectal cancer (RC). METHODS: This retrospective cohort study was conducted at two centers by three senior surgeons. Both institutions’ prospectively maintained…
Read moreAbstract This review aimed to determine the overall sensitivity and specificity of indocyanine green (ICG) near-infrared (NIR) fluorescence in sentinel lymph node (SLN) detection in Colorectal cancer (CRC). A systematic search in electronic databases was conducted. Twelve studies including 248 patients were reviewed. The median sensitivity, specificity, and accuracy rates were 73.7, 100, and 75.7.…
Read moreAbstract Indocyanine green fluorescence imaging is a surgical tool with increasing applications in colorectal surgery. This tool has received acceptance in various surgical disciplines as a potential method to enhance surgical field visualisation, improve lymph node retrieval, and decrease the incidence of anastomotic leaks. In colorectal surgery specifically, small studies have shown that intraoperative fluorescence…
Read moreAbstract Anastomotic leak (AL) after colorectal surgery is a devastating complication; decreased blood perfusion is an important risk factor. Surgeons rely on subjective measures to assess bowel perfusion. Fluorescence imaging (FI) with indocyanine green (ICG) provides a real-time objective assessment of intestinal perfusion. Areas covered: A PubMed search using the terms ‘fluorescence imaging’, ‘indocyanine green’,…
Read moreAbstract BACKGROUND: Intraoperative incisionless fluorescent cholangiography (IOIFC) has been described to identify extrahepatic biliary anatomy. Potential advantages of the routine use of intraoperative incisionless fluorescent cholangiography were evaluated in a consecutive series of cases. METHODS: A total of 45 patients undergoing laparoscopic cholecystectomy between January and July 2013 were consented and included in this study.…
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