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This video demonstrates Fluorescence Angiography During Laparoscopic Sleeve Gastrectomy performed by Dr. R. K. Mishra at World Laparoscopy Hospital. A new technology involving indocyanine green (ICG) fluorescence angiography has been introduced to assess tissue perfusion and perform vascular mapping during laparoscopic surgery. The purpose of this video was to describe the use of this technology to identify the variable blood supply patterns to the stomach and gastroesophageal (GE) junction during laparoscopic sleeve gastrectomy (LSG), which may help in preserving the blood supply and preventing ischemia-related leaks.

Fluorescence imaging is currently being used for multiple applications across multiple subspecialties of surgery. Regarding gastrointestinal surgery, this technology can be used to assess proper tissue perfusion and vascular mapping of the patient's arterial/venous anatomy, as described in this article. Our group is currently exploring this technology in LSG cases to perform “perfusion-preserving” dissection and checking for adequate perfusion of the sleeve product afterward.