Clinical use of endovenous indocyanine green during rectosigmoid segmental resection for endometriosis

Renato Seracchioli, Diego Raimondo, Arena A, Alessandro Arena, Zanello M, Margherita Zanello, Mohamed Mabrouk, Mabrouk M
Fertility and sterility · 2018 · vol. 109(6) , pp. 1135 · doi:10.1016/j.fertnstert.2018.02.122 · PMID:29935649 · W2809437333
article OA: closed CC0 ⤵ 34 in-corpus citations
🔓 Open OA copy View on OpenAlex View on PubMed View at publisher
⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-07-09 ⓘ

This case report describes the use of intravenous indocyanine green during rectosigmoid endometriosis resection to visualize bowel perfusion and assess neoanastomosis vascularization.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

Abstract

ObjectiveTo describe a new use of endovenous indocyanine green (ICG) to allow real-time visualization of bowel perfusion in women with recto-sigmoid endometriosis who may be candidates for segmental resection.DesignStep-by-step explanation of this method using descriptive text and educational video.SettingTertiary level referral academic center.Patient(s)A nulliparous 36-year-old woman affected by a large rectal endometriotic nodule was referred for severe dysmenorrhea, dyspareunia, hematochezia, and dyschezia, despite progestinic therapy.Intervention(s)An intravenous injection of 1.5 mL solution containing 3.75 mg dose of ICG for intraoperative fluorescence imaging.Main outcome measure(s)Evaluation of blood perfusion of bowel and rectal endometriosis nodule. Evaluation of neoanastomosis vascularization after bowel resection.Result(s)The procedure of endometriosis removal was performed using the daVinciXi surgical platform (Intuitive Surgical, Sunnyvale, CA). After ovarian endometriosis removal and adhesiolysis, we identified the endometriosis nodule on the anterior surface of the rectum. Pararectal, rectovaginal, and retrorectal spaces were dissected with a nerve-sparing technique. Indocyanine green was administered through a peripheral line. A near-infrared camera head enabled vision of the colorant after latency of a few seconds. We observed the ischemic area around the rectal nodule and perfusion areas upstream and downstream from the lesion. We selected the transecting line for rectal resection, taking account of this objective evaluation, beyond the limits of macroscopic disease. After direct mechanical anastomosis, we checked the rectal vascularization with ICG.Conclusion(s)To the best of our knowledge, this is the first reported use of endovenous ICG during a bowel resection for deep endometriosis. Endovenous ICG is proposed during surgery for rectosigmoid endometriosis to assess the perfusion of the bowel and select the transecting line. With ICG fluorescence imaging, we can objectively evaluate whether blood supply to the anastomosis is adequate. Endovenous ICG for objective vascular assessment is simple and rapid to use, and no complications related to ICG use were recorded.

My notes (saved in your browser only)

Condition tags

endometriosis

MeSH descriptors

Endometriosis Indocyanine Green Monitoring, Intraoperative Rectal Diseases Sigmoid Diseases Administration, Intravenous Adult Anastomosis, Surgical Anastomosis, Surgical Colon, Sigmoid Colon, Sigmoid Colon, Sigmoid Colon, Sigmoid Colon, Sigmoid Digestive System Surgical Procedures Digestive System Surgical Procedures Endometriosis Endometriosis Female Humans

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

Cited by (33)

Source provenance

europepmc
last seen: 2026-10-01T06:15:55.914501+00:00
openalex
last seen: 2026-06-10T17:14:06.276822+00:00
pubmed
last seen: 2026-05-13T22:19:43.094626+00:00
unpaywall
last seen: 2026-09-17T06:32:46.214484+00:00
License: CC0 · commercial use OK