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THE CLINICAL USE OF INDOCYANINE GREEN AS A NEAR-INFRARED FLUORESCENT CONTRAST AGENT FOR IMAGE-GUIDED LAPAROSCOPIC SURGERY

Konstantinos G Tsallis, Pr, Nikolaos Antoniou, Dr, Orestis Ioannidis, Ioannis Mantzoros, Savvas Simeonidis, Stathis Kotidis, Manousos-G Pramateutakis, Lydia Loutzidou, Dimitris Konstantaras, Stamatis Angelopoulos. Aristotle University

Background: Advances in laparoscopic imaging the past decade has brought to light new achievements as major contributions to intraoperative decision during laparoscopic procedures. Among these are the use of high definition and 3D imaging systems, and more recently indocyanine green (ICG) near infrared (NIR) fluorescence guided laparoscopy. The aim of this study was to present our experience with different laparoscopic procedures using ICG fluorescence imaging

Patients and methods: 52 ICG guided laparoscopic procedures were performed: 42 cholecystectomies (36 ellective and 6 urgent) 1  adrenalectomy, 2 segmental hepatectomies , 4  colectomies, 1  spleenctomy, 1 lymph node biopsy and 1 accesory spleen laparoscopic rescection mimicking pancreatic tail cancer. Visualization of structures was provided by a high resolution camera and a light source emitting both visible and near infra-red (NIR) light.

Results: After injection of ICG, vessels,organs and biliary structures were clearly identified. No injection-related adverse effects were reported. ICG-fluorescent imaging identified both of the microscopically confirmed HCC and CRC metastases in surgical specimens. Also provide valuable information to conduct a safe laparoscopic cholecystectomy spleenectomy, adrenalectomy and ensure adequate vascular supply for colectomy, or find lymph nodes. There were no bile duct injuries or anastomotic leaks.

Conclusions: The use of (ICG), a non-radioactive, inexpensive fluorescent dye, in laparoscopic operations permits visualizing anatomic structures, perfusion and perfusion defects as well as the biliary and lymphatic system. In liver surgery, the system is used to visualize liver metastases or primary tumors of the liver. Due to its versatile cross-discipline applications, in our opinion we consider this fluorescence technology as a future standard imaging technique that will be found in every OR.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 95104

Program Number: P609

Presentation Session: Poster Session (Non CME)

Presentation Type: Poster

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