The use of live fluorescence staining techniques in surgery: a review

Intraoperative fluorescence may allow improvements to existing surgical procedures or offer scope for new operations. Despite articles describing its use dating back more than a decade, its emergence as a commonly used adjunct is still anticipated. While awareness and availability of special equipment may limit the uptake of these techniques, intraoperative fluorescence could represent a key innovation in the future of surgery. Further awareness of techniques and more clinical trials are needed to promote a wide base of clinical expertise from which further innovations can be made. This literature review begins with a discussion of the physics and chemistry of fluorophores and the properties needed for use in clinical practice. Uses in the majority of surgical specialties will be considered and the current literature addressed. Common uses include delineating hollow visci such as blood vessels or demonstrating pathology such as tumors. Fluorescent stains used have been safe, effective, and often easier to use than the established methods. Finally, novel materials such as antibodies and nanoparticles will be mentioned as new developments on the horizon of intraoperative fluorescent staining.