Indocyanine green fluorescence angiography after full‐thickness bowel resection for rectosigmoid endometriosis: A multicentric experience with quantitative analysis

Raimondo, Diego; Maletta, Manuela; Malzoni, Mario; Cosentino, Francesco; Scambia, Giovanni; Falcone, Francesca; Coppola, Marina; Turco, Luigi Carlo; Borghese, Giulia; Raffone, Antonio; Casadio, Paolo; Fabbri, C.; Corsi, Cristiana; Seracchioli, Renato

doi:10.1002/ijgo.14059

Cited by 10 publications

(14 citation statements)

References 35 publications

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“…Of the included studies, one study [19] was a prospective, single-center, randomized within subject clinical trial, while 15 studies were observational: 4 retrospective [14,15,20,21] and 11 prospective [1,2,7,12,16,20,[22][23][24][25][26][27].…”

Section: Studies and Patients' Characteristicsmentioning

confidence: 99%

“…Thirteen studies assessed patients with endometriosis [1,2,7,12,14,15,[19][20][21][22][23][24][25], with the following NIR-ICG applications:…”

Section: Studies and Patients' Characteristicsmentioning

confidence: 99%

“…− to localize ureteral course (2 studies [20,23]); − to assess ureteral perfusion after conservative surgery (1 study [1]); − to improve visualization of endometriotic lesions (6 studies [7,12,19,21,22,24]); − to evaluate the different rectosigmoid endometriosis (RSE) vascular patterns and the correlation with clinicopathological data (1 study [2]); − to assess bowel vascularization after deep infiltrating endometriosis (DIE) surgery to reduce the risk of fistula (2 studies after full-thickness bowel resection [14,15] and 1 study after shaving technique [25]).…”

Section: Studies and Patients' Characteristicsmentioning

confidence: 99%

“…(3) in the resection of deep infiltrating nodules [22]; such improvement was not found in one study [19]; − intraoperatively assessing bowel perfusion during recto-sigmoid endometriosis nodules (RSE) surgery, with improvement in patient safety, intraoperative decision-making process and surgical outcomes [2,14,15,25].…”

Section: Nir-icg Performancementioning

confidence: 99%

“…For example, it can be used as a guide during endometriosis surgery facilitating intraoperative diagnosis of occult peritoneal and deep endometriotic lesions at white light [7,12,13]. Furthermore, it has been proven useful in the evaluation for anastomotic perfusion assessment after discoid or segmental resection for rectosigmoid endometriosis (RSE) [14,15]. NIR-ICG dye may also help in the intraoperative assessment of organ perfusion and ischemia after ovarian detorsion and assist the surgeon's intraoperative decision [16].…”

Section: Introductionmentioning

confidence: 99%

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The Use of near Infra-Red Radiation Imaging after Injection of Indocyanine Green (NIR–ICG) during Laparoscopic Treatment of Benign Gynecologic Conditions: Towards Minimalized Surgery. A Systematic Review of Literature

et al. 2022

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Background and Objectives: To assess the use of near infrared radiation imaging after injection of indocyanine green (NIR–ICG) during laparoscopic treatment of benign gynecologic conditions. Materials and Methods: A systematic review of the literature was performed searching 7 electronic databases from their inception to March 2022 for all studies which assessed the use of NIR–ICG during laparoscopic treatment of benign gynecological conditions. Results: 16 studies (1 randomized within subject clinical trial and 15 observational studies) with 416 women were included. Thirteen studies assessed patients with endometriosis, and 3 studies assessed non-endometriosis patients. In endometriosis patients, NIR–ICG use appeared to be a safe tool for improving the visualization of endometriotic lesions and ureters, the surgical decision-making process with the assessment of ureteral perfusion after conservative surgery and the intraoperative assessment of bowel perfusion during recto-sigmoid endometriosis nodule surgery. In non-endometriosis patients, NIR–ICG use appeared to be a safe tool for evaluating vascular perfusion of the vaginal cuff during total laparoscopic hysterectomy (TLH) and robotic-assisted total laparoscopic hysterectomy (RATLH), and intraoperative assessment of ovarian perfusion in adnexal torsion. Conclusions: NIR–ICG appeared to be a useful tool for enhancing laparoscopic treatment of some benign gynecologic conditions and for moving from minimally invasive surgery to minimalized surgery. In particular, it might improve treatment of endometriosis (with particular regard to deep infiltrating endometriosis), benign diseases requiring TLH and RATLH and adnexal torsion. However, although preliminary findings appear promising, further investigation with well-designed larger studies is needed.

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Section: Studies and Patients' Characteristicsmentioning

confidence: 99%

“…Thirteen studies assessed patients with endometriosis [1,2,7,12,14,15,[19][20][21][22][23][24][25], with the following NIR-ICG applications:…”

Section: Studies and Patients' Characteristicsmentioning

confidence: 99%

Section: Studies and Patients' Characteristicsmentioning

confidence: 99%

Section: Nir-icg Performancementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

The Use of near Infra-Red Radiation Imaging after Injection of Indocyanine Green (NIR–ICG) during Laparoscopic Treatment of Benign Gynecologic Conditions: Towards Minimalized Surgery. A Systematic Review of Literature

et al. 2022

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The implications of the anatomy of the nerves and vessels in the treatment of rectosigmoid endometriosis

et al. 2023

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Endometriosis is a common benign gynecological disease characterized by the presence of endometrial glands and stroma outside the uterus. It can be defined as endometrioma, superficial peritoneal endometriosis or deep infiltrating endometriosis (DIE) depending on the location and the depth of infiltration of the organs. In 5%–12% of cases, DIE affects the digestive tract, frequently involving the distal part of the sigmoid colon and rectum. Surgery is generally recommended in cases of obstructive symptoms and in cases with pain that is non‐responsive to medical treatment. Selection of the most optimal surgical technique for the treatment of bowel endometriosis must consider different variables, including the number of lesions, eventual multifocal lesions, as well as length, width and grade of infiltration into the bowel wall. Except for some major and widely accepted indications regarding bowel resection, established international guidelines are not clear on when to employ a more conservative approach like rectal shaving or discoid resection, and when, instead, to opt for bowel resection. Damage to the pelvic autonomic nervous system may be avoided by detection of the middle rectal artery, where its relationship with female pelvic nerve fibers allows its use as an anatomical landmark. To reduce the risk of potential vascular and nervous complications related to bowel resection, a less invasive approach such as shaving or discoid resection can be considered as potential treatment options. Additionally, the middle rectal artery can be used as a reference point in cases of upper bowel resection, where a trans mesorectal technique should be preferred to prevent devascularization and denervation of the bowel segments not affected by the disease.

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NIR‐II imaging with ICG for identifying perforators, assessing flap status and predicting division timing of pedicled flaps in a porcine model

Wang

et al. 2022

Journal of Biophotonics

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The use of skin flaps to fill large defects is a key surgical technique in reconstructive surgery, effective real‐time in vivo imaging for flap design and use is urgent. Currently, fluorescent imaging in the second NIR window (NIR‐II; 1000‐1700 nm) is characterized by non‐radiation, less expensive and higher resolution in comparisons with the first NIR window (NIR‐I; 700‐900 nm) and other traditional imaging modalities. In this article, we identified the location and numbers of perforators and choke zone via NIR‐II imaging. Then, eight abdominal perforator flaps were established and the perfusion zones were evaluatedat special time points. Finally, after eight pedicled flaps establishment, NIR‐II imaging was used to guide the optimal timing for division of flap pedicle. The results showed that NIR‐II fluorescence imaging with indocyanine green (ICG) can reliably visualize vascular supply, which makes it to be an accurate and in vivo imaging approach to flap clinical design and use.

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Indocyanine green fluorescence angiography after full‐thickness bowel resection for rectosigmoid endometriosis: A multicentric experience with quantitative analysis

Cited by 10 publications

References 35 publications

The Use of near Infra-Red Radiation Imaging after Injection of Indocyanine Green (NIR–ICG) during Laparoscopic Treatment of Benign Gynecologic Conditions: Towards Minimalized Surgery. A Systematic Review of Literature

The Use of near Infra-Red Radiation Imaging after Injection of Indocyanine Green (NIR–ICG) during Laparoscopic Treatment of Benign Gynecologic Conditions: Towards Minimalized Surgery. A Systematic Review of Literature

The implications of the anatomy of the nerves and vessels in the treatment of rectosigmoid endometriosis

NIR‐II imaging with ICG for identifying perforators, assessing flap status and predicting division timing of pedicled flaps in a porcine model

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