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ICG Image-Guided Surgery with the Assessment for Anastomotic Safety

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Innovative Endoscopic and Surgical Technology in the GI Tract

Abstract

Humans have been performing gastrointestinal anastomosis since the 1700s, when it was a highly controversial procedure associated with near-universal mortality. Advances in the 1800s included recognition of the importance of serosal apposition and the development of aseptic surgery which greatly improved outcomes. Technological growth led to surgical stapling devices, laparoscopy, and even surgical robots to further reduce morbidity and mortality, but anastomotic leak remains a feared and not infrequent complication. Various methods of intraoperative anastomotic evaluation have been employed, but leaks persist. It has been hypothesized that anastomotic malperfusion could contribute to breakdown, but surrogates for perfusion to the anastomosis might be misleading. Fluorescent angiography with indocyanine green dye allows for real-time, intraoperative visualization of blood flow to the bowel. Inadequate perfusion may then be addressed intraoperatively, which may decrease complications. Determining optimal procedures and applications remains an area of active research.

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Authors and Affiliations

  1. Department of Surgery- Division of Colon and Rectal Surgery, University of California San Diego, San Diego, CA, USA

    Sonia L. Ramamoorthy

  2. Department of Surgery, University of California San Diego, San Diego, CA, USA

    Jared S. Matson

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  1. Sonia L. Ramamoorthy
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  2. Jared S. Matson
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Correspondence to Sonia L. Ramamoorthy .

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  1. Division of Minimally Invasive Surgery, Center for Fluorescence-Guided Surgery, Department of Surgery, University of California San Diego, La Jolla, CA, USA

    Santiago Horgan

  2. Center for the Future of Surgery, University of California San Diego, La Jolla, CA, USA

    Karl-Hermann Fuchs

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Ramamoorthy, S.L., Matson, J.S. (2021). ICG Image-Guided Surgery with the Assessment for Anastomotic Safety. In: Horgan, S., Fuchs, KH. (eds) Innovative Endoscopic and Surgical Technology in the GI Tract . Springer, Cham. https://doi.org/10.1007/978-3-030-78217-7_34

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