Introduction

Rgis video demonstrates The Role of Indocyanine Green (ICG) in Laparoscopic Surgery - Sryker Masterclass. Laparoscopic surgery has revolutionized the field of minimally invasive procedures, offering patients reduced postoperative pain, shorter hospital stays, and quicker recoveries. As surgical techniques evolve, the need for enhanced visualization and precision has led to the incorporation of new technologies. One such advancement is the use of Indocyanine Green (ICG) fluorescence imaging, which has become an invaluable tool in a variety of laparoscopic procedures.

What is Indocyanine Green (ICG)?

ICG is a water-soluble, tricarbocyanine dye that fluoresces in the near-infrared (NIR) spectrum. When administered intravenously, it binds to plasma proteins and is rapidly cleared by the liver. Under NIR light, it emits fluorescence, allowing real-time imaging of vascular structures, bile ducts, and tissue perfusion.

Mechanism of Action

Once injected, ICG circulates through the bloodstream and accumulates in targeted areas depending on the application. A specialized laparoscopic camera equipped with NIR capabilities can detect ICG fluorescence, providing surgeons with a dynamic map of internal anatomy during the procedure.

Applications in Laparoscopic Surgery

1. Biliary Mapping in Cholecystectomy

One of the most common uses of ICG in laparoscopic surgery is during laparoscopic cholecystectomy. ICG enhances visualization of the cystic duct, common bile duct, and hepatic ducts, reducing the risk of bile duct injury—a significant complication in gallbladder surgery.

2. Colorectal Surgery

In colorectal resections, ICG helps assess bowel perfusion before anastomosis. By confirming adequate blood supply to both ends of the resected colon, surgeons can significantly reduce the risk of anastomotic leakage, one of the most feared postoperative complications.

3. Lymphatic Mapping and Sentinel Lymph Node Detection

ICG is used for lymphatic mapping, especially in oncologic surgeries such as colorectal, gastric, and gynecological cancers. It helps identify sentinel lymph nodes, guiding lymphadenectomy while preserving uninvolved lymphatic structures.

4. Hepatic and Pancreatic Surgery

ICG fluorescence assists in the delineation of liver segments and identification of liver tumors, which may not be visible under standard white light. This enhances the precision of hepatic resections. In pancreatic surgery, ICG can help in visualizing pancreatic ducts and vasculature.

5. Urological Procedures

In partial nephrectomies, ICG can be used to assess renal perfusion and demarcate tumor margins. It also aids in preserving as much healthy renal tissue as possible.

Advantages of ICG in Laparoscopic Surgery

• Real-time visualization of anatomical structures.

• Reduced complication rates through better identification of critical anatomy.

• Enhanced surgical precision, particularly in oncological resections.

• Minimal risk and side effects — ICG is generally well tolerated.

Limitations and Considerations

• Requires specialized imaging equipment.

• ICG use is contraindicated in patients with iodine allergies.

• Timing of administration is crucial; early or late injection may lead to suboptimal imaging.

• Cost and availability can be limiting factors in some healthcare settings.

Future Perspectives

As technology advances, the integration of ICG with robotic platforms and artificial intelligence will further refine surgical accuracy. Research is ongoing into newer fluorophores and multiplex imaging that can visualize multiple structures simultaneously, pushing the boundaries of precision surgery.

Conclusion

The use of Indocyanine Green in laparoscopic surgery represents a significant leap toward safer, more effective, and personalized surgical care. By enhancing intraoperative visualization, ICG contributes to better outcomes and greater confidence for surgeons in complex procedures.

 

In this informative video, Dr. R.K. Mishra explains the revolutionary role of Indocyanine Green (ICG) fluorescence imaging in laparoscopic surgery. Learn how ICG is transforming minimally invasive procedures by improving visualization of critical structures such as bile ducts, lymph nodes, and vascular anatomy.

This advanced technique significantly enhances the safety and accuracy of surgeries like:
✔️ Laparoscopic Cholecystectomy
✔️ Colorectal Surgery
✔️ Oncologic Resections
✔️ Gynecological Procedures
✔️ Sentinel Lymph Node Mapping

Watch how real-time near-infrared fluorescence with ICG can reduce complications, improve intraoperative decision-making, and help surgeons achieve better patient outcomes.

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