Safety of indocyanine green use in bariatric and metabolic surgery

Intraoperative indocyanine green (ICG) is increasingly used in surgery. In metabolic and bariatric surgery, it allows visualization of the tissues and blood supply to anastomoses in real time.

The objective of this prospective cohort study was to evaluate the safety and efficacy of ICG usage in metabolic and bariatric surgery.

The study was conducted from July 2022 to December 2023. A total of 171 metabolic and bariatric procedures with ICG perfusion tests were performed, comprising 93 sleeve gastrectomies, 17 one-anastomosis gastric bypasses, 51 Roux-en-Y gastric bypasses, 7 primary single anastomosis duodeno-ileal bypasses with sleeve gastrectomies, and 3 redo surgeries.

Out of 171 patients included in the study, 143 (83.6%) were women. Mean (SD) age of the participants was 41.8 (9.7) years, and mean (SD) body mass index was 44.6 (6.3) kg/m². Mean (SD) operation time was 92.9 (47.7) minutes, and mean (SD) length of hospital stay was 2.1 (0.8) days. Surgical complications occurred in 4 patients (2.3%). No local or general adverse symptoms or complications, including allergic reactions, were observed after intravenous administration of ICG. The patients' allergies did not influence adverse events related to the administration of the dye.

The use of intraoperative ICG in metabolic and bariatric surgery is safe, and adverse events and dye-related complications are very rare.