The Integration of Indocyanine Green (ICG) to Optimize Benign Gynecological Surgery

Abstract

Study Objective

To demonstrate a surgical tutorial that highlights the integration of Indocyanine Green (ICG) in complex gynecological surgeries.

Design

A video footage illustrating the use of ICG in various surgical settings.

Setting

An endometriosis and adenomyosis referral center.

Patients or Participants

Patients undergoing robotic-assisted laparoscopic surgery for deep endometriosis, nerve-sparing hysterectomies, and uterus-sparing adenomyosis surgeries.

Interventions

Intravenous ICG (IV ICG) is used alongside conventional white light to enhance the detection of superficial endometriosis and assess bowel vascularization before and after anastomosis. Additionally, IV ICG aids in identifying hypogastric nerves, vessels, and ureters during deep endometriosis surgeries. Diluted intraluminal ICG is another beneficial modality that can be injected directly into the ureters during cystoscopy to identify the ureters, administered in the uterine cavity to detect breaches, and optimize adenomyosis excision. Intraluminal ICG can also be injected into the bladder or rectum, allowing for precise mucosal-sparing shaving excision of bladder and bowel endometriosis.

Measurements and Main Results

N/A.

Conclusion

ICG has various applications in benign gynecological surgery, guiding intraoperative decision-making. It could be considered a potential candidate to further enhance patient safety, decrease morbidity, and improve surgical outcomes.