Role of fluorescence imaging for intraoperative intestinal assessment in gynecological surgery: a systematic review
Systematic review / meta-analysis
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⤵ 2 in-corpus citations
AI-generated summary
This systematic review found indocyanine green fluorescence imaging effectively assesses bowel vascularization in gynecological surgery, aiding intraoperative decisions to prevent complications like anastomotic leakage and fistulas.
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Abstract
BACKGROUND: Our aim was to review the current knowledge of the role of fluorescence imaging for intraoperative intestinal assessment in gynecological surgery.
MATERIAL AND METHODS: A computer-based systematic review was performed from 2000 to 2020. All articles describing the use of indocyanine green (ICG) applied to bowel assessments in gynecology or endometriosis surgery were considered for review.
RESULTS: ICG is an effective tool for assessing bowel vascularization, potentially preventing anastomotic leakage and recto-vaginal fistula and can therefore be useful for endometriosis surgery or bowel assessment in gynecological oncology procedures. Real-time characterization of the hypovascular pattern of endometriotic nodules has been associated with a larger nodule size and lower microvessel density, helping surgeons choose the best transecting line and the most appropriate technique. ICG angiography allows for a laparoscopic and intrarectal bowel assessment, which can act as a double check of bowel perfusion, enabling the assessment of mucosa vascularization. ICG fluorescence can guide intraoperative decision-making after intestinal anastomosis, discoid resection, and rectal shaving, preventing anastomotic leakage and postoperative recto-vaginal fistula in low anterior resections.
CONCLUSIONS: ICG angiography provides a better intestinal assessment. Larger, prospective, randomized controlled studies are needed to validate the technique and confirm these encouraging results.
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Cited by (3)
- Application of intraluminal indocyanine green in advanced endometriosis surgery 2026
- Systematic use of intraureteral indocyanine green: a game changer in endometriosis surgery. A proof-of-concept study 2024
- Indocyanine green angiography: promising tool in intestinal assessment during gynecological oncology and severe endometriosis surgery 2022
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chemicals 1
indocyanine green
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