Fluorescence Guided Surgery FAQ
What is Fluorescence Guided Surgery?
Fluorescence Guided Surgery (FGS) is a medical imaging technique that uses fluorescent dye to identify anatomic structures during surgical procedures. FGS typically involves three components:
1. Fluorescent Dye: The most commonly used fluorescent agent is Indocyanine Green (IGC). ICG has been approved by the FDA in 1959 and has demonstrated to be safe and can be used in different surgical applications.
2. An Excitation Source:The ICG is illuinated with a specific light source that causes the dye to glow. This enhances the structure in which the surgeon needs to see.
What are the advantages of Fluorescence Guided Surgery?
Despite many advances in preoperative medical imaging such as CT and MRI scans, surgeons still almost exclusively operate under white (visible) light during their procedures and must rely on their ability to see and feel target tissues. Unfortunately, most human tissue looks very similar under white light, and it can be very difficult to distinguish one tissue from another or to completely remove a target tissue such as a tumor. In addition, a surgeon can only see the topmost layer of tissue under white light while tissues and structures underneath will remain hidden.
FGS essentially gives the surgeon the ability to ‘see’ in a different wavelength of light that would otherwise be invisible to them. By combining this visual ability with the special dyes that glow in those wavelengths surgeons can much more precisely target or avoid certain organs or tissues. In addition, the near-infrared light used in FGS can more easily penetrate human tissues, allowing surgeons to see ‘through’ layers of tissue and organs.
In addition to allowing a surgeon to see what otherwise would be invisible, FGS has the added advantage of being a real-time imaging process. Whereas traditional imaging like X-Rays, CT Scans, and MRI scans can provide excellent images, they are all limited to providing static images.
Think of FGS as being the equivalent of giving a surgeon GPS whereas before they were working with only a map!
How is FGS Currently Being Used?
This table from this article outlines the current clinical and preclinical fluorescence-guided surgery techniques:
|Sentinel lymph node mapping||Breast cancer|
|Head and neck cancer|
|Coronary artery bypass grafting|
|Abdominal aortic aneurysm|
|Parathyroid and thyroid grands|
|Tumor imaging||Malignant glioma|
|Head and neck cancer|
|Lung and chest masses|
|Solitary fibrous tumor (pancreas)|
|Renal cell carcinoma|
|Basal cell carcinoma|
|Laparoscopic- and robotic-assisted surgeries||Nephrectomy|
|Fluorescence endoscopy||Brain aneurysm|
|Head and Neck tumor|
|Marking tumor||Colonic tattooing|