Application of indocyanine green fluorescence angiography in laparoscopic sleeve gastrectomy: preliminary results

In recent years, as researchers have discovered that indocyanine green (ICG) near-infrared fluorescence imaging offers excellent tissue penetration, the application of ICG fluorescence angiography (ICG-FA) in various laparoscopic procedures has become increasingly widespread and gets significant therapeutic efficacy. However, its use in laparoscopic sleeve gastrectomy (LSG) has not been extensively reported.

A retrospective study was conducted on the clinical data of 291 patients who underwent LSG at our clinical medical center between September 2021 and November 2024. The patients were divided into two groups: Group A, consisting of 195 cases (without intraoperative use of ICG-FA), and Group B, comprising 96 cases (with intraoperative use of ICG-FA). Statistical software was utilized for data processing and analysis.

The mean blood loss along the staple line was 6.53 ± 1.69 mL in Group A and 2.57 ± 1.81 mL in Group B (p < 0.001). The mean operative time was 99.01 ± 22.63 min in Group A and 94.04 ± 22.88 min in Group B (p < 0.05). The mean hospital stay was 5.89 ± 1.48 days in Group A and 4.95 ± 2.92 days in Group B (p < 0.001). Among all 291 patients, there were 2 cases of gastric leakage, with 1 case occurring in each group, 4 patients experienced postoperative bleeding, with 2 cases occurring in each group.

Findings from our institutional data indicate that while ICG-FA demonstrated statistically significant reductions in staple line bleeding (due to suture needle punctures), shorter mean operative time, and decreased average hospital stay, its clinical benefits in LSG for morbid obesity appear limited compared to its established utility in other laparoscopic procedures. Furthermore, ICG-FA did not reduce the incidence of postoperative complications, such as gastric leaks or bleeding.