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Fluorescence and tracers in surgery: the coming future.

Salvador Morales-Conde¹, Laura Navarro-Morales², Francisco Moreno-Suero²

¹Servicio de Cirugía General y Digestiva, Hospital Universitario Virgen Macarena, Facultad de Medicina, Universidad de Sevilla, Sevilla, Spain; Servicio de Cirugía General y Digestiva, Hospital Quironsalud Sagrado Corazón, Sevilla, Spain.

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Summary

Image-guided surgery, including Indocyanine Green (ICG) fluorescence and emerging technologies like hyperspectral imaging, is revolutionizing surgical approaches. These advancements enhance visualization, improve tissue perfusion assessment, and aid in precise tumor identification for better surgical outcomes.

Keywords:

Angiografía de fluorescencia Autofluorescence Autofluorescencia Cirugía Cuantificación Fluorescence angiography Imagen Imaging Indocyanine green (ICG)Quantification Surgery Tracers Trazadores verde de indocianina (ICG)

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Area of Science:

Surgical innovation
Medical imaging
Minimally invasive surgery

Background:

Minimally invasive surgery has continuously evolved since its inception.
Recent advancements include robotic surgery, artificial intelligence, and image-guided techniques.
Indocyanine Green (ICG) fluorescence has emerged as a key tool in modern surgical visualization.

Purpose of the Study:

To review the clinical applications of emerging image-guided technologies in general surgery.
To highlight the revolutionary impact of these advancements on surgical practice.
To discuss the potential of new tracers and non-tracer-based perfusion assessment methods.

Main Methods:

Review of current literature on image-guided surgery and related technologies.
Discussion of applications of ICG fluorescence in identifying anatomical structures, assessing perfusion, and detecting tumors.
Exploration of novel tracers and non-tracer techniques like hyperspectral imaging.

Main Results:

ICG-guided fluorescence aids in identifying anatomy, assessing perfusion, and locating tumors and lymphatic drainage.
Development of new tracers for tumor cells and ureters is progressing.
Hyperspectral imaging offers tracer-free tissue perfusion assessment.
ICG quantification is poised to further enhance its utility.

Conclusions:

Technological advancements, including ICG fluorescence and hyperspectral imaging, represent a significant revolution in surgery.
These innovations promise to enhance precision in tumor identification, perfusion assessment, and anatomical visualization.
A timely review of these technologies' clinical applications in general surgery is essential for future practice.