Abstract
Background The use of intraoperative fluorescence images with indocyanine green (ICG) has recently
been described as an aid in decision-making during surgical procedures in adults.
We present our first experiences with different laparoscopic procedures performed
in children using ICG fluorescence images.
Material and Method We have used ICG fluorescence imaging technique in varicocele ligation, two nephrectomies,
cholecystectomy, and one case of aortocoronary fistula closure. All procedures were
performed through a minimally invasive approach. A high definition camera equipped
with a visible infrared light source and gray-scale vision technology was used.
After injection of ICG before or during the laparoscopic procedure, precise identification
of vascular anatomy and bile duct architecture were easily identified. Fluorescence
helped to assess blood flow from the spermatic vessels, define the variability of
renal vascularization, and determine the precise location of the aortocoronary fistula.
Biliary excretion of the ICG allowed the definition of the biliary tract.
Conclusion Fluorescein-assisted images allowed a clear definition of the anatomy and safe surgical
maneuvers during surgical procedures. The ICG imaging system seems to be simple and
safe. Larger and more specific studies are needed to confirm its applicability, expand
its indications, and address its advantages and disadvantages.
Keywords
indocyanine green - laparoscopy - fluorescence - thoracoscopy - minimally invasive
surgery
