The Role of ICG During the SADI-S Procedure

Area of Science:

• Surgical Innovation
• Medical Imaging
• Bariatric Surgery

Background:

• Indocyanine green (ICG) is a fluorescent dye used since the 1950s for medical imaging.
• ICG aids in identifying anatomical structures like the biliary tract, blood vessels, and tissue perfusion in abdominal surgery.
• Its application in bariatric surgery can enhance both primary and revisional procedures.

Purpose of the Study:

• To investigate the utility of indocyanine green (ICG) in the Single Anastomosis Duodeno-Ileal bypass with Sleeve Gastrectomy (SADI-S) procedure.
• To highlight critical aspects and applications of ICG during SADI-S.

Main Methods:

• A case series of 22 morbidly obese patients undergoing laparoscopic SADI-S.
• Utilized specific ICG dosages and timings for arteriography, common bile duct visualization, and leak testing, adhering to International Society for Fluorescence Guided Surgery guidelines.
• Employed a combination of ICG and methylene blue for leak testing via an orogastric tube.

Main Results:

• ICG facilitated identification of anatomical structures and assessment of tissue perfusion during SADI-S.
• The dye was effective in detecting potential anastomotic leaks.
• No adverse events related to ICG administration were reported in the patient cohort.

Conclusions:

• Indocyanine green is a safe and valuable tool for enhancing surgical outcomes in SADI-S procedures.
• ICG improves intraoperative visualization and aids in complication prevention, particularly for leak detection.
• The study supports the integration of ICG into the SADI-S surgical workflow for morbidly obese patients.