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Use of IndoCyanine Green (ICG) Fluorescence in Laparoscopic Adrenalectomy

Ajay Bhandarwar, MS, FMAS, FIAGES, FBMS, FICS, Eham L Arora, MS, Shubham Gupta, MS, Gagandeep Talwar, Jasmine Agarwal, Saurabh Gandhi, MS, FMAS, FIAGES, FBMS, FALS, Amol Wagh, MS, FMAS, FIAGES, FBMS, FICS. Grant Government Medical College & Sir JJ Group of Hospitals, India

Objective: Commercially available laparoscopic systems with IndoCyanine Green Fluorescence allow an intraoperative angiographic view of vasculature. Laparoscopic adrenalectomy is the standard of care for adrenal lesions & the success success of surgery hinges on correctly identifying the adrenal vasculature with differs between the two sides. We demonstrate the use of IndoCyanine Green Fluorescence system during laparoscopic adrenalectomy with the intent of speedy vascular identification, which can help in reducing operative times and increasing patient safety.

Materials and Methods: We performed laparoscopic adrenalectomy with ICG Fluorescence system on 52 patients undergoing over a  period of two years. ICG system provides various modes with real time endoscopic and near infrared fluorescence imaging . This enables coupling of images and simultaneous dissection without switching to normal white light mode while dissection.

Results: ICG fluorescence guidance helps in better delineation of vascular anatomy.The borders between tumor and adjacent tissue was clearly demarcated. The surgeries were performed safely with minimal blood loss and short operative times. No major complications were seen.

Conclusions: Laparoscopic resection of adrenal neoplasms under ICG fluorescence guidance  can be used to clearly identify vascular structures and enhance the borders of the tumor, confirming successful division of vascular pedicles. This technology has the potential to improve operative times & patient safety in these surgeries.


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

Abstract ID: 87275

Program Number: S135

Presentation Session: Solid Organ Session

Presentation Type: Podium

395

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