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DOI: 10.1055/s-0042-1750029
Indocyanine Green-Based Fluorescence-Guided Surgery in a Male Infant with Anorectal Malformation
Funding We thank the Medical Research Council (grant number MR/T005491/1), the Wellcome/EPSRC Centre for Interventional and Surgical Sciences at University College London (WEISS, grant number 203145Z/16/Z), and Mr Bassam Slim from Medtronic who supported the pilot with the EleVisionTM IR platform.
Abstract
Reconstructive techniques for complex anorectal malformations (ARMs) require intestinal pull-through on vascular pedicles. Traditionally, the visual inspection of the intestinal perfusion is the sole modality adopted to assess tissue viability.
In this article, we report the case of a child with a rectourethral prostatic fistula, who had a Peña's descending colostomy with distal mucous fistula in the neonatal period and a posterior sagittal anorectoplasty at 6 months of life. The ARM repair was guided by indocyanine green (ICG), which was intravenously administered to evaluate the blood flow of the intestinal pull-through using the EleVision IR system (Medtronic Ltd, U.K.). ICG-based fluorescence-guided surgery helped to define the proximal resection margin, impacting intraoperative decision making, and no postoperative complications occurred.
We envisage that this technology will become part of the armory of pediatric surgeons soon, by reducing the risk of intra- and postoperative complications.
Keywords
anorectal malformation - fluorescence-guided surgery - indocyanine green - children - real-time imagingPublication History
Received: 26 November 2021
Accepted: 22 January 2022
Article published online:
23 August 2022
© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
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