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Intraoperative fluorescence imaging in different surgical fields: Consensus among 140 intercontinental experts
Fernando Dip1, Emanuele Lo Menzo2, Michael Bouvet3
1Hospital de Clínicas Jos e de San Martín, Buenos Aires, Argentina.
Surgery
|November 25, 2022
Summary
Intraoperative fluorescence imaging with indocyanine green is safe and enhances surgical visualization, though dosing and timing require further research for optimal use across specialties.
Area of Science:
- Surgical Innovation
- Medical Imaging
- Clinical Practice
Background:
- Intraoperative fluorescence imaging with indocyanine green (ICG) is increasingly supported by evidence.
- Significant variability exists in its application and no consensus guidelines are available.
- This study addresses the need for standardized guidelines across surgical fields.
Purpose of the Study:
- To establish consensus among international experts on the use of intraoperative fluorescence imaging with ICG.
- To identify areas of agreement and disagreement across six surgical specialties.
- To inform the development of clinical guidelines for ICG use.
Main Methods:
- Delphi consensus surveys were conducted with international surgical experts.
- Experts voted on consensus statements regarding ICG use in six surgical scenarios.
- Consensus was defined as ≥70% intervoter agreement.
Main Results:
- Consensus was achieved on 16 out of 29 shared statements among 140 experts.
- ICG is considered extremely safe and enhances anatomical visualization, impacting procedures and reducing risk.
- Dosing and timing of ICG are procedure-specific, with ongoing variability and need for further research.
Conclusions:
- Intraoperative fluorescence imaging with ICG is a valuable tool with growing adoption in surgery.
- Further research is needed to optimize ICG dosing and timing for specific applications.
- The findings support the increasing integration of this technology in clinical practice and research.
