Use of indocyanine green in endometriosis surgery

Bar-Shavit Y, Yochay Bar-Shavit, Jaillet L, Lucie Jaillet, Pauline Chauvet, Chauvet P, Michel Canis, Nicolas Bourdel, Bourdel N
Fertility and sterility · 2018 · vol. 109(6) , pp. 1136–1137 · doi:10.1016/j.fertnstert.2018.02.113 · PMID:29885885 · W2807126036
article OA: closed CC0 ⤵ 21 in-corpus citations
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This paper discusses the application of indocyanine green during endometriosis surgery to improve visualization of lesions.

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Abstract

ObjectiveTo report and visually demonstrate the feasibility of using indocyanine green (ICG) in endometriosis surgery and to discuss potential benefits.DesignICG fluorescent imaging has been validated to assess tissue perfusion with clinical use in many medical fields, including gynecology and digestive surgery, but has not described in endometriosis surgery for bowel assessment. To our knowledge, there is no validated, objective, intraoperative method to assess the vascularity of the operated bowel in endometriosis surgery, a potentially good indicator for postoperative fistula formation. Our center is conducting a registered clinical trial examining the use of ICG to evaluate the bowel vascularization after endometriosis rectal shaving surgery, and the potential role in reducing fistula rates (Institutional Review Board no 2016-002773-35).SettingTertiary university hospital.Patient(s)Three patients undergoing laparoscopic surgery for deep infiltrating endometriosis (DIE) with the use of a rectal shaving procedure.Interventions(s)Patients undergoing laparoscopic surgery for DIE with a rectal shaving procedure were injected with ICG intravenously at the end of endometriosis resection.Main outcome measuresVisual assessment of the rectal shaving area was assessed as fluoresced or not with the use of a Likert-type scale (0 = no fluorescence; 4 = very good fluorescence).Result(s)After ICG injection, all three patients have showed very good fluorescence levels at the rectal shaving area with no adverse reactions. Other uses of ICG are demonstrated throughout the video (vaginal cuff, ureter, and ovary assessment).Conclusion(s)ICG fluorescent imaging is feasible in endometriosis surgery, and there is an ongoing trial to determine if its use reduces postoperative fistula formation.Clinical trial registration numberNCT03080558.

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Condition tags

endometriosis

MeSH descriptors

Digestive System Surgical Procedures Endometriosis Indocyanine Green Optical Imaging Postoperative Complications Rectal Diseases Administration, Intravenous Digestive System Surgical Procedures Digestive System Surgical Procedures Endometriosis Endometriosis Female Humans Indocyanine Green Laparoscopy Laparoscopy Laparoscopy Monitoring, Intraoperative Monitoring, Intraoperative Optical Imaging

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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.

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License: CC0 · commercial use OK