Abstract:

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.

Authors:

Thomas Carus, MD Professor of Minimally Invasive Surgery Department of Surgery, Center for Minimally Invasive Surgery University of Bremen, Klinikum Bremen-Ost, Head of Surgery, Hospital Bremen-Ost, Bremen, Germany, Professor, Department Of Medical Engineering University of Applied Sciences, Bremerhaven, Germany, Rainer Dammer PhD, Professor, Department of Medical Engineering, University of Applied Sciences, Bremerhaven, Germany

PMID: 23315721

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