Applications of Indocyanine Green in Surgery: A Single Center Case Series

Overview

Journal Ann Med Surg (Lond)

Publisher Wolters Kluwer

Specialty Medical Education

Date 2022 May 31

PMID 35637998

Authors

Talha Ahmed

Manohar V Pai

Esha Mallik

George M Varghese

Sharad Ashish

Abhijith Acharya

Avinash Krishna

Affiliations

Soon will be listed here.

Abstract

Background: Fluorescence imaging using indocyanine green (ICG) has revolutionized commonly performed general surgical procedures by providing superior anatomic imaging and enhancing safety for patients. ICG, when injected, shows a bright green fluorescence when subjected to the near infra-red (NIR) spectrum.

Materials And Methods: We employed the use of ICG in Laparoscopic cholecystectomy, Intestinal Colorectal Anastomosis and Hernia to assess vascularity of resected ends and bowel viability, Sentinel Lymph node mapping, Vascular surgery to assess amputation stump success and in assessing Flap Vascularity and healing.

Results: ICG when administered had successfully shown bright green fluorescence in different cases thereby aiding in surgical procedures.

Conclusion: Routine intraoperative use of ICG could pave the way for a more objective assessment of different surgical circumstances and thereby reduce personalized barriers to aciurgy. ICG fluorescence therefore seems to be a promising apparatus in standard general surgical procedures minimizing untoward errors and improving patient conformance.

Citing Articles

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References

Alander J, Kaartinen I, Laakso A, Patila T, Spillmann T, Tuchin V . A review of indocyanine green fluorescent imaging in surgery. Int J Biomed Imaging. 2012; 2012:940585. PMC: 3346977. DOI: 10.1155/2012/940585. View

Mast B . Comparison of magnetic resonance angiography and digital subtraction angiography for visualization of lower extremity arteries. Ann Plast Surg. 2001; 46(3):261-4. DOI: 10.1097/00000637-200103000-00010. View

Mothes H, Donicke T, Friedel R, Simon M, Markgraf E, Bach O . Indocyanine-green fluorescence video angiography used clinically to evaluate tissue perfusion in microsurgery. J Trauma. 2004; 57(5):1018-24. DOI: 10.1097/01.ta.0000123041.47008.70. View

Boni L, David G, Mangano A, Dionigi G, Rausei S, Spampatti S . Clinical applications of indocyanine green (ICG) enhanced fluorescence in laparoscopic surgery. Surg Endosc. 2014; 29(7):2046-55. PMC: 4471386. DOI: 10.1007/s00464-014-3895-x. View

Agha R, Sohrabi C, Mathew G, Franchi T, Kerwan A, ONeill N . The PROCESS 2020 Guideline: Updating Consensus Preferred Reporting Of CasESeries in Surgery (PROCESS) Guidelines. Int J Surg. 2020; 84:231-235. DOI: 10.1016/j.ijsu.2020.11.005. View

Perry D, Bharara M, Armstrong D, Mills J . Intraoperative fluorescence vascular angiography: during tibial bypass. J Diabetes Sci Technol. 2012; 6(1):204-8. PMC: 3320839. DOI: 10.1177/193229681200600125. View

Samies J, Gehling M, Serena T, Yaakov R . Use of a fluorescence angiography system in assessment of lower extremity ulcers in patients with peripheral arterial disease: A review and a look forward. Semin Vasc Surg. 2016; 28(3-4):190-4. DOI: 10.1053/j.semvascsurg.2015.12.002. View

Kell M, Kerin M . Sentinel lymph node biopsy. BMJ. 2004; 328(7452):1330-1. PMC: 420275. DOI: 10.1136/bmj.328.7452.1330. View

Urbanavicius L, Pattyn P, Van de Putte D, Venskutonis D . How to assess intestinal viability during surgery: A review of techniques. World J Gastrointest Surg. 2011; 3(5):59-69. PMC: 3110878. DOI: 10.4240/wjgs.v3.i5.59. View

10.

Sugie T, Ikeda T, Kawaguchi A, Shimizu A, Toi M . Sentinel lymph node biopsy using indocyanine green fluorescence in early-stage breast cancer: a meta-analysis. Int J Clin Oncol. 2016; 22(1):11-17. DOI: 10.1007/s10147-016-1064-z. View

11.

Horgan P, Gorey T . Operative assessment of intestinal viability. Surg Clin North Am. 1992; 72(1):143-55. DOI: 10.1016/s0039-6109(16)45632-x. View

12.

Snijders H, Wouters M, van Leersum N, Kolfschoten N, Henneman D, de Vries A . Meta-analysis of the risk for anastomotic leakage, the postoperative mortality caused by leakage in relation to the overall postoperative mortality. Eur J Surg Oncol. 2012; 38(11):1013-9. DOI: 10.1016/j.ejso.2012.07.111. View

13.

Hung W, Chan C, Ying M, Chong S, Mak K, Yip A . Randomized clinical trial comparing blue dye with combined dye and isotope for sentinel lymph node biopsy in breast cancer. Br J Surg. 2005; 92(12):1494-7. DOI: 10.1002/bjs.5211. View

14.

Furukawa H, Hayashi T, Oyama A, Funayama E, Murao N, Yamao T . Effectiveness of intraoperative indocyanine-green fluorescence angiography during inguinal lymph node dissection for skin cancer to prevent postoperative wound dehiscence. Surg Today. 2014; 45(8):973-8. DOI: 10.1007/s00595-014-0996-z. View

15.

Yang A, Hartranft C, Reiss A, Holden C . Improving Outcomes for Lower Extremity Amputations Using Intraoperative Fluorescent Angiography to Predict Flap Viability. Vasc Endovascular Surg. 2017; 52(1):16-21. DOI: 10.1177/1538574417740048. View

16.

Kingham T, Pachter H . Colonic anastomotic leak: risk factors, diagnosis, and treatment. J Am Coll Surg. 2009; 208(2):269-78. DOI: 10.1016/j.jamcollsurg.2008.10.015. View

17.

Karliczek A, Harlaar N, Zeebregts C, Wiggers T, Baas P, van Dam G . Surgeons lack predictive accuracy for anastomotic leakage in gastrointestinal surgery. Int J Colorectal Dis. 2009; 24(5):569-76. DOI: 10.1007/s00384-009-0658-6. View

18.

Dorfman D, Pu L . The value of color duplex imaging for planning and performing a free anterolateral thigh perforator flap. Ann Plast Surg. 2014; 72 Suppl 1:S6-8. DOI: 10.1097/SAP.0000000000000177. View

19.

Cahill R, Mortensen N . Intraoperative augmented reality for laparoscopic colorectal surgery by intraoperative near-infrared fluorescence imaging and optical coherence tomography. Minerva Chir. 2010; 65(4):451-62. View

20.

Reinhart M, Huntington C, Blair L, Heniford B, Augenstein V . Indocyanine Green: Historical Context, Current Applications, and Future Considerations. Surg Innov. 2015; 23(2):166-75. DOI: 10.1177/1553350615604053. View