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Updated: May 31, 2025

The Role of Indocyanine Green Fluorescence in Complex Laparoscopic Cholecystectomy Navigation

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The impact of indocyanine green fluorescence angiography (ICG-FA) on anastomotic leak rates and postoperative

Khadeija Hussain¹, G Balamurugan², Chetna Ravindra³

¹Department of General Surgery, Princess Royal University Hospital, King's College Hospital NHS Foundation Trust, Farnborough Common, Orpington, BR6 8ND, UK. khadeijahussain@gmail.com.

Surgical Endoscopy

|January 22, 2025

Summary

Indocyanine Green Fluorescence Angiography (ICG-FA) significantly lowers anastomotic leak rates in colorectal surgery. This technique safely assesses bowel perfusion, aiding surgical decisions without increasing operative time or complications.

Keywords:

Anastomotic leak Colorectal anastomosis Colorectal resection Fluorescence angiography ICG Indocyanine green

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Published on: July 24, 2019

Area of Science:

Colorectal Surgery
Surgical Oncology
Medical Imaging

Background:

Anastomotic leak (AL) is a critical complication in colorectal surgery.
Indocyanine Green Fluorescence Angiography (ICG-FA) is a novel technique for assessing intraoperative bowel perfusion.
This review examines ICG-FA's impact on AL rates and patient outcomes.

Purpose of the Study:

To systematically review the effectiveness of ICG-FA in reducing anastomotic leak rates.
To evaluate the impact of ICG-FA on various postoperative outcomes.
To assess the safety and reliability of ICG-FA in colorectal surgery.

Main Methods:

Systematic literature search across major databases (PubMed, MEDLINE, Google Scholar).
Inclusion of RCTs, prospective, and retrospective cohort studies adhering to PRISMA guidelines.
Data extraction on AL rates, surgical modifications, and postoperative complications; quality assessment using established tools.

Main Results:

Sixteen studies with 3231 patients (1562 ICG-FA, 1669 controls) were analyzed.
Significantly lower AL rates observed in the ICG-FA group (5.18% vs. 11.50%, p < 0.01).
ICG-FA influenced surgical plans in 16.31% of cases; operative time and complication rates remained comparable.

Conclusions:

ICG-FA is a safe and effective tool for reducing anastomotic leaks in colorectal surgery.
The technique reliably assesses bowel perfusion, supporting its integration into surgical protocols.
Further high-quality RCTs are recommended to optimize ICG-FA application.