Using an indocyanine green fluorescent imaging technique for laparoscopic rectal cancer surgery: a case report

Colorectal cancer is a clinically common malignancy with high incidence and mortality rates. Surgery remains the preferred treatment option for colorectal cancer. Laparoscopic surgery is more widely used than open surgery due to its advantages of reduced surgical trauma and faster postoperative recovery. However, complications such as anastomotic leakage, bleeding, intestinal obstruction, and intra-abdominal infections can still occur, prolonging hospital stays and impairing patient recovery. In particular, anastomotic leakage is a severe complication that significantly affects the postoperative recovery of patients. Indocyanine green (ICG) fluorescence imaging (FI) combined with 4K laparoscopy has emerged as a promising approach for enhancing surgical quality. ICG is a water-soluble tricarbocyanine dye with low toxicity, a strong binding affinity to plasma proteins, and a short half-life, making it suitable for intraoperative use. It enables the real-time visualization of blood flow, which facilitates the detection of metastases, the assessment of anastomotic perfusion, and precise lymph node dissection. This technology has been shown to improve the detection of positive lymph nodes and reduce postoperative complications. We report the case of a 66-year-old male patient with rectal adenocarcinoma who underwent fluorescent laparoscopy-assisted radical resection of rectal cancer (Dixon procedure). The patient initiated ambulation on postoperative day (POD) 1, followed by successful flatus passage and bowel movement initiation on POD 2, and was discharged on POD 6 after the removal of the pelvic drain. This article highlights the application techniques and advantages of ICG-FI laparoscopic technology in rectal cancer surgery to provide a reference for its clinical application.