Indocyanine Green Fluorescent Angiography During Laparoscopic Sleeve Gastrectomy: Preliminary Results

Furia, M.; Romano, Lucia; Salvatorelli, Andrea; Brandolin, Denise; Lomanto, Davide; Cianca, Giovanni; Schietroma, M; Carlei, F; Giuliani, Antonio

doi:10.1007/s11695-019-04085-y

Cited by 27 publications

(31 citation statements)

References 28 publications

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“…Its worldwide know that gastric bypass and sleeve gastrectomies are not free from adverse events; having the most worrying complications anastomosis and gastric leaks. Few studies in literature describes ICG use in perfusion assessment during bariatric procedures and preliminary results with clinical benefits still inconclusive (13,20) .…”

Section: Discussionmentioning

confidence: 99%

“…Bariatric surgery also represents a novel branch for this technology, especially to estimate the risk of leak after sleeve gastrectomies, gastric bypass anastomosis and revisional procedures (FIGURE 2.A, B). Di furia et al (13) described a 43 patients analysis of minimally invasive sleeve gastrectomies with ICG perfusion assessment however without a well established correlation between gastric leak and sleeve conduit blood supply. Larger series and prospective trials still are needed in order to provide higher levels of evidence sup-porting ICG usage for tissue assessment in standard procedures.…”

Section: Upper Gi Tract Surgerymentioning

confidence: 99%

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Indocyanine Green Fluorescence Imaging in Robotic Surgery: State of Art, Tips and Tricks in Current Applications

Morrell

Morrell-Junior

et al. 2021

Arq. Gastroenterol.

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BACKGROUND: Fluorescent imaging with indocyanine green is an emerging technology whose benefits are put in perspective. OBJECTIVE: This article reports essential principles and approaches of intraoperative fluorescence in general surgery bringing familiarity to its practical usage. Our group describes possible pitfalls and provides tips and tricks for training surgeons making their attempts easier and reproducible during practice. METHODS: This study overviews the most structured concepts, practical applications and its tricks in robotic fluorescence guided imaging surgery with indocyanine green. Possible pitfalls are emphasized and emerging fields of application are put in a perspective. RESULTS: Guided information and practical applications in several surgical fields are described for a safe and reproducible indocyanine green fluorescence imaging use. CONCLUSION: Robotic assisted surgery combined to fluorescence imaging technology represents a logical evolution in image guided surgery and technology familiarity with guided information may represent a wider and safer spectrum of use in surgeons’ hands.

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Section: Discussionmentioning

confidence: 99%

Section: Upper Gi Tract Surgerymentioning

confidence: 99%

Indocyanine Green Fluorescence Imaging in Robotic Surgery: State of Art, Tips and Tricks in Current Applications

Morrell

Morrell-Junior

et al. 2021

Arq. Gastroenterol.

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“…No demographic data were available for 86 patients, not having been reported in the study by Ortega et al [12] No intraoperative complications were reported in any of the studies. Only one leak occurred postoperatively, in a patient who underwent a laparoscopic sleeve gastrectomy, as reported by Di Furia et al [11] ICG was used intravenously to assess proper vascularization of the staple line in four of five studies.…”

Section: Resultsmentioning

confidence: 61%

“…Our search found no comparative studies. One of the studies was a case report [9]; the remaining four included studies [10][11][12][13] from prospectively maintained databases analyzed retrospectively (Table 1). A total of 240 patients were included in the studies.…”

Section: Resultsmentioning

confidence: 99%

The use of indocyanine green in bariatric surgery: A systematic review

Carrano

Lorenzo

2020

Journal of Gastric Surgery

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Fluorescence-guided surgery is a recently developed technique in minimally invasive surgery in which a fluorescent dye is used to complement the surgeon’s judgment in making real-time intraoperative assessment of organ vascularization and proper tissue perfusion. This technique has been adopted in several different surgical subspecialties with positive results, particularly in hepatobiliary and colorectal surgery. More recently, it has also been applied in bariatric surgery, with the aim of reducing the incidence of leaks. This paper reviews the relevant literature on the topic.

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“…A blue dye test is usually performed before the ending intervention, to confirm tightness of the linear suture and exclude the presence of leakage. In addition, we used to perform a Indocyanine Green (ICG) test intraoperatively, to evaluate adequate blood perfusion of staple line, especially next to the critical angle of His [ 9 ].…”

Section: Methodsmentioning

confidence: 99%

Endoscopic Double-Pigtail Catheter (EDPC) Internal Drainage as First-Line Treatment of Gastric Leak: A Case Series during Laparoscopic Sleeve Gastrectomy Learning Curve for Morbid Obesity

Lazzarin

Furia

Romano

et al. 2020

Minimally Invasive Surgery

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Objectives. The prevalence of morbid obesity has dramatically increased over the last several decades worldwide, currently reaching epidemic proportions. Gastric leak (GL) remains the potentially fatal main complication after sleeve gastrectomy (SG) for morbid obesity. To our knowledge, there are no standardized guidelines for GL treatment after laparoscopic sleeve gastrectomy (LSG) yet. The aim of this study was to represent our institutional preliminary experience using the endoscopic double-pigtail catheter (EDPC) as the method of internal drainage and propose it as first-line treatment in case of GL after LSG. Methods. One hundred and seventeen patients were admitted to our surgical department and underwent laparoscopic sleeve gastrectomy (LSG) for morbid obesity from March 2014 to June 2019. In 5 patients (4.3%) of our series, GL occurred as a complication of LSG. EPDC was the stand-alone procedure of internal drainage and GL first-line treatment. The internal pig tail was endoscopically removed from 30th to 40th POD in all cases. Results. Present data (clinical, biochemical, and instrumental tests) showed a complete resolution of GL, with promotion of a pseudodiverticula and complete re-epithelialization of leak. Follow-up was more strict than usual (clinical visit and biochemical test on 7th, 14th, and 21st day after discharge; a CT scan with gastrografin on 30th day from discharge if clinical visit and exams were normal). Conclusion. This was a preliminary retrospective observational study, conducted on 5 patients affected by GL as a complication of LSG for morbid obesity. EDPC maintains the safety, efficacy, and nonexpensive characteristic and may be proposed as better first-line treatment in case of GL after bariatric surgery.

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Indocyanine Green Fluorescent Angiography During Laparoscopic Sleeve Gastrectomy: Preliminary Results

Cited by 27 publications

References 28 publications

Indocyanine Green Fluorescence Imaging in Robotic Surgery: State of Art, Tips and Tricks in Current Applications

Indocyanine Green Fluorescence Imaging in Robotic Surgery: State of Art, Tips and Tricks in Current Applications

The use of indocyanine green in bariatric surgery: A systematic review

Endoscopic Double-Pigtail Catheter (EDPC) Internal Drainage as First-Line Treatment of Gastric Leak: A Case Series during Laparoscopic Sleeve Gastrectomy Learning Curve for Morbid Obesity

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