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Open Access 01-07-2015 | New Technology

Clinical applications of indocyanine green (ICG) enhanced fluorescence in laparoscopic surgery

Authors: Luigi Boni, Giulia David, Alberto Mangano, Gianlorenzo Dionigi, Stefano Rausei, Sebastiano Spampatti, Elisa Cassinotti, Abe Fingerhut

Published in: Surgical Endoscopy | Issue 7/2015

Abstract

Background

Recently major developments in video imaging have been achieved: among these, the use of high definition and 3D imaging systems, and more recently indocyanine green (ICG) fluorescence imaging are emerging as major contributions to intraoperative decision making during surgical procedures. The aim of this study was to present our experience with different laparoscopic procedures using ICG fluorescence imaging.

Patients and methods

108 ICG-enhanced fluorescence-guided laparoscopic procedures were performed: 52 laparoscopic cholecystectomies, 38 colorectal resections, 8 living-donor nephrectomies, 1 laparoscopic kidney autotransplantation, 3 inguino-iliac/obturator lymph node dissections for melanoma, and 6 miscellanea procedures. Visualization of structures was provided by a high definition stereoscopic camera connected to a 30° 10 mm scope equipped with a specific lens and light source emitting both visible and near infra-red (NIR) light (KARL STORZ GmbH & Co. KG, Tuttlingen, Germany). After injection of ICG, the system projected high-resolution NIR real-time images of blood flow in vessels and organs as well as highlighted biliary excretion .

Results

No intraoperataive or injection-related adverse effects were reported, and the biliary/vascular anatomy was always clearly identified. The imaging system provided invaluable information to conduct a safe cholecystectomy and ensure adequate vascular supply for colectomy, nephrectomy, or find lymph nodes. There were no bile duct injuries or anastomotic leaks.

Conclusions

In our experience, the ICG fluorescence imaging system seems to be simple, safe, and useful. The technique may well become a standard in the near future in view of its different diagnostic and oncological capabilities. Larger studies and more specific evaluations are needed to confirm its role and to address its disadvantages.

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Title: Clinical applications of indocyanine green (ICG) enhanced fluorescence in laparoscopic surgery
Authors: Luigi Boni
Giulia David
Alberto Mangano
Gianlorenzo Dionigi
Stefano Rausei
Sebastiano Spampatti
Elisa Cassinotti
Abe Fingerhut
Publication date: 01-07-2015
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 7/2015
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-014-3895-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Clinical applications of indocyanine green (ICG) enhanced fluorescence in laparoscopic surgery

Abstract

Background

Patients and methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Patients and methods

Results

Conclusions

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