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Updated: Aug 6, 2026
03:27
The Role of Indocyanine Green Fluorescence in Complex Laparoscopic Cholecystectomy Navigation
Published on: January 31, 2025
Intraoperative Visualization of the Left Common Iliac Vein Using Indocyanine Green via Lower-Extremity Injection
Shizuka Sakurai1, Go Hirata1, Megumi Yamasaki1
1Department of Gynecology, Yokohama City University Medical Center, Yokohama, Japan.
Journal of Minimally Invasive Gynecology
|July 25, 2026
Summary
Intraoperative indocyanine green (ICG) fluorescence imaging using lower-extremity injection successfully visualized the left common iliac vein (LCIV) in 88.6% of patients during laparoscopic sacral colpopexy (LSC). This safe and feasible technique aids LCIV identification.
Area of Science:
- Minimally Invasive Surgery
- Surgical Imaging Technologies
- Vascular Anatomy Visualization
Background:
- Laparoscopic sacral colpopexy (LSC) requires accurate identification of pelvic vasculature, particularly the left common iliac vein (LCIV).
- Standard visualization methods can be challenging, necessitating improved intraoperative techniques.
Purpose of the Study:
- To evaluate the feasibility and safety of using intraoperative indocyanine green (ICG) fluorescence imaging via lower-extremity venous injection for LCIV visualization during LSC.
- To determine the success rate of LCIV visualization and assess for any associated vascular injuries or adverse events.
Main Methods:
- A retrospective two-center study included patients undergoing LSC between April 2022 and January 2026.
- Indocyanine green (ICG) was injected into the left dorsal foot vein before retroperitoneal incision to visualize the LCIV.
- The primary outcome was the LCIV visualization rate; secondary outcomes included vascular injury and ICG-related adverse events.
Main Results:
- The study included 35 patients, with successful LCIV visualization achieved in 31 (88.6%).
- No intraoperative vascular injuries were reported.
- No adverse events related to ICG administration occurred.
Conclusions:
- Intraoperative ICG fluorescence imaging via lower-extremity venous injection is a feasible and safe method for visualizing the LCIV during LSC.
- This technique shows potential as a valuable adjunct for identifying the LCIV in patients with typical vascular anatomy.
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