Indocyanine green fluorescence imaging during partial adrenalectomy.

Area of Science:

• Surgical Oncology
• Medical Imaging
• Endocrinology

Background:

• Indocyanine green (ICG) fluorescence imaging is an emerging technology for assessing tissue vascularity, distinction, and tumor localization during surgery.
• Its potential role in laparoscopic partial adrenalectomy warrants investigation.

Purpose of the Study:

• To investigate the utility of ICG fluorescence imaging during laparoscopic partial adrenalectomy.
• To evaluate ICG's effectiveness in identifying adrenal borders, tumors, and assessing remnant vascularity.

Main Methods:

• ICG fluorescence imaging was performed during laparoscopic partial adrenalectomy for pheochromocytoma and Cushing's syndrome.
• Two intravenous ICG boluses were administered: one for initial visualization and another post-resection to assess remnant vascularity.
• A Storz NIR/ICG endoscopic system was used for visualization.

Main Results:

• ICG imaging assisted in visualizing adrenal borders and the adrenal vein during left adrenalectomies.
• It facilitated the identification and complete resection of hypofluorescent pheochromocytomas.
• On the right side, ICG offered less benefit due to clearer anatomy.
• Post-adrenalectomy, four adrenal remnants showed strong vascularization, and two showed reasonable vascularization.

Conclusions:

• ICG fluorescence imaging can be a valuable tool for guiding partial adrenalectomy.
• It aids in assessing the vascularity of the remaining adrenal tissue, crucial for endocrine function.