Recently, in vivo fluorescence imaging using indocyanine green (ICG) has actively been applied to open and then laparoscopic HPB surgery, for intraoperative visualization of biological structures and assessment of blood perfusion. This webinar will discuss the methods and results.
Intraoperative fluorescence imaging will develop into an essential navigation tool enabling surgeons to identify the extent of cancer spread, anatomical variations, and a risk of postoperative complications in each individual case, enhancing accuracy and safety of HPB surgery.
- Recognize the soft tissue challenges in abdominal wall reconstruction
- Understand the options to evaluate perfusion of the abdominal wall
- Become familiar with the steps to use of fluorescence in the assessment of abdominal wall perfusion
The webinar will describe the basic principles of fluorescence guided surgery with special interest in the field of organ perfusion control using fluorescent angiography. An extensive review of the available literature will also be discussed.
The assessment of the flap perfusion in reconstruction surgery is mostly based on clinical evaluation. Unfortunately, surgeons still face some risk of complications if the flap tissue is not well perfused. Indocyanine Green (ICG) angiography allows the surgeon to define the boundaries of the perforator perfusion zones of a flap with high sensitivity, avoiding partial flap loss and fat necrosis. With the combination of preoperative Computed Tomography Angiography (CTA) and intraoperative ICG, we can define the post-dissection vascular re-balance, speed up the flap dissection and avoid post-operative flap complications. This lecture will provide you a clear understanding of the procedure …
Esophagectomy for esophageal cancer is still associated with a high morbidity and mortality. Anastomotic leaks are a major source of morbidity after esophagectomy with gastric pull-up. In large part they occur as a consequence of poor blood perfusion in the gastric graft. Risk factors like nicotine, neoadjuvant radiotherapy, hypertension and diabetes are considered to increase anastomotic leakage rate. Ongoing challenge is to improve technical options for better patients’ outcome. Because of knowledge that quality of gastric tube perfusion is obviously related with anastomotic healing the use of fluorescence controlled construction of gastric tube makes this procedure safer for our patients. …