Bowel and ureteral assessment by indocyanine green real‐time visualization during deep infiltrating endometriosis surgery – a video vignette

Abstract

to the accuracy or integrity of any part of the work are appropriately investigated and resolved. Ethical approval All procedures involving human participants were performed in accordance with the ethical standards of the institutional and/or national research committee and the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. This article does not contain any studies using animals.

Indocyanine green in the surgical management of endometriosis: A systematic review

“…These 17 studies included six video‐articles (8 patients), 19‐22,26,27 one case report (1 patient), 16 one case series (6 patients), 14 two retrospective observational studies (57 patients), 12,24 seven prospective longitudinal studies, 8,11,13,15,18,23,25 one of which randomized 15 within‐subject (196 patients). When insufficient information was reported in the available papers, if necessary, we consulted the authors for further completing data; any disagreement was discussed and resolved by consensus.…”

“…The simultaneous involvement of multiple abdominal and pelvic organs, such as ureter and bowel, is rather common in patients with advanced endometriosis. In two video articles 21,27 the use of ICG, in laparoscopy and robot‐assisted surgery, turned out to be very helpful in DIE surgery, enabling real‐time evaluation of ureters and bowel and a successful resection of nodules overlying the ureter and rectum. Recently, Raimondo et al have published a prospective pilot study to describe the different rectosigmoid endometriosis vascular patterns and to find a correlation with clinicopathologic data.…”

“…Previous retroperitoneal surgery, fibrosis and the reduction of neoangiogenesis related to the use of estrogen‐progestin or gonadotropin‐releasing hormone agonist, may be responsible for an altered microcirculation at the level of peritoneal lesions or DIE nodules 8 . The variability among the various authors, regarding the times reported between the administration of ICG and the visualization of the fluorescence, should also be considered, with times for viewing varying from a few seconds to 30 minutes 8,11,12,15,16,23,25‐27 …”

“…Given that more than half were single cases described in the form of video-articles/case reports/case series, high risk was reported for "time" and "size". These 17 studies included six video-articles (8 patients), [19][20][21][22]26,27 one case report (1 patient), 16 one case series (6 patients), 14 two retrospective observational studies (57 patients), 12,24 seven prospective longitudinal studies, 8,11,13,15,18,23,25 one of which randomized…”

“…18,19 Currently there are no clear and uniform indications concerning the use of NIR-ICG in the surgical treatment of endometriosis, and the scientific literature appears unclear about the dosage of dye to be used, the waiting time from the injection or its real effectiveness. 8,10,23,25,27 The aim of this review is to offer an overview of NIR-ICG in the surgical treatment of PE and DIE.…”