Laparoscop fluorescence angiography with indocyanine green to control the perfusion of gastrointestinal anastomoses intraoperatively
Carus, T.; Dammer, R.
Surgical Technology International 22: 27-32
2012
ISSN/ISBN: 1090-3941 PMID: 23315721 Document Number: 661923
The principle of fluorescence angiography using indocyanine green has been known for a long time and was used especially by photographs and ophthalmologists for retinal diagnostics. After one publication about perfusion control in open surgery we were the first who examined the perfusion of colorectal anastomoses by laparoscopic fluorescence angiography intraoperatively. Since 2008, 49 laparoscopic operations (45 colorectal anastomoses, 4 gastric sleeve resections) were performed using the fluorescence control. In all cases a correct perfusion of the anastomotic/stapler region could be shown. In cases of decreased perfusion a resection of this area could have been necessary. The laboratory tests with isolated, perfused pig colon could show areas with hypoperfusion after dissection of segmental arteries. Laparoscopic fluorescence angiography could become a standard method to detect a decreased perfusion intraoperatively. Further studies will be needed to show if the rate of anastomotic insufficiency can be lowered by using this new method.