Optimal Indocyanine Green Dosage for Repetitive Angiography for Laparoscopic Colorectal Surgery

Area of Science:

• Surgical Oncology
• Medical Imaging
• Gastroenterology

Background:

• Assessing colonic perfusion is crucial in laparoscopic colorectal surgery.
• Current methods may require optimization for repetitive use.
• Laser-assisted near-infrared (NIR) imaging offers enhanced visualization.

Purpose of the Study:

• To determine the minimal effective dose of indocyanine green (ICG) for colonic perfusion assessment.
• To evaluate ICG doses using a laser-assisted laparoscopic NIR camera system.
• To optimize repetitive ICG angiography in colorectal surgery.

Main Methods:

• 15 patients undergoing right hemicolectomy received varying ICG doses (0.01-0.05 mg/kg) intravenously.
• Quantitative analysis of fluorescence intensity and perfusion parameters was performed.
• Artificial intelligence (AI)-based perfusion pattern analysis was utilized.

Main Results:

• Doses of 0.02-0.05 mg/kg demonstrated significantly higher quantitative analysis accessibility (84.7-100%) compared to 0.01 mg/kg (48.0%).
• Minimal ICG doses (0.02-0.05 mg/kg) resulted in acceptable AI-based perfusion patterns (66.4-100%).
• Washout times were significantly faster with minimal doses (39.0 s) versus conventional doses (117.5 s).

Conclusions:

• Minimal indocyanine green doses (0.02-0.05 mg/kg) are effective for colonic perfusion assessment.
• These doses optimize repetitive ICG angiography with laser-assisted laparoscopic NIR cameras.
• This approach enhances accuracy and efficiency in laparoscopic colorectal surgery.