Free vascularized medial femoral condyle (MFC) bone grafts can lead to increased vascularity of the proximal pole and restore scaphoid architecture in scaphoid nonunions. The intraoperative perfusion assessment of the bone graft is challenging because the conventional clinical examination is difficult.
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Intraoperative fluorescence angiography (FA) is of potential added value during ileal pouch-anal anastomosis (IPAA), especially after vascular ligation as part of lengthening measures. In this study, time to fluorescent enhancement during FA was evaluated in patients with or without vascular ligation during IPAA.
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This study aimed to clarify the clinical effects of the indocyanine green (ICG)-fluorescence imaging (FI) technique for determination of liver transection lines during laparoscopic partial liver resection for liver tumours. This was a retrospective study including 112 patients who underwent laparoscopic partial liver resection for liver tumours. These enrolled patients were divided into an ICG-FI group (n = 55) and a non-ICG-FI group (n = 57) according to the availability of the ICG-FI. The clinicopathological characteristics of patients between two groups were compared before and after propensity score matching.
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Laparoscopic cholecystectomy (LC) with fluorescent cholangiography using indocyanine green dye (FC) identifies extrahepatic biliary structures, potentially augmenting the critical view of safety. We aim to describe trends for the largest single-centre cohort of patients undergoing FC in LC. A retrospective review of a prospectively maintained database identified patients undergoing LC with FC at a single academic institution.
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A consecutive case series of supraclavicular artery island flaps was designed using indocyanine green angiography (IcG-A) in head and neck reconstruction to demonstrate its utilization in supraclavicular artery island flap (SCAIF) head and neck reconstruction. IcG-A was used consecutively between April 2014 and July 2015 to evaluate its use in flap design, inset, and intraoperative decision-making in five patients undergoing head and neck reconstruction.
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12 September, 2022; Universidad de Buenos Aires, Argentina: The Universidad de Buenos Aires (UB) Faculty of Medicine, together with the Hospital de Clinicas “Jose de San Martin” are pleased to announce the launch of a new International Training Center for surgeons in Argentina, dedicated to Fluorescence Guided Surgery.
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Designing a skin flap that perfectly covers the anatomical and dynamic territories is challenging. Tissues capturing territories beyond may be insufficiently perfused, and these hypoperfused areas can lead to partial flap necrosis. Indocyanine green angiography (ICGA) is an effective tool for identifying hypoperfused areas. This retrospective study proposes a standardized strategy for managing the hypoperfused area identified by ICGA in pre-expanded extended lower trapezius myocutaneous (e-LTMC) flaps
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Accurate localization of pulmonary nodules is the main difficulty experienced in wedge resection. Commonly used localization methods have their own advantages and disadvantages. However, clinical work has demonstrated that intraoperative indocyanine green localization under electromagnetic navigation bronchoscopy/virtual navigation bronchoscopy (VNB) is more advantageous than conventional methods for patients with multiple pulmonary nodules undergoing simultaneous surgery, especially for those undergoing bilateral lung surgery.
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Intraoperative assessment of mastectomy flaps and nipple-areola complex (NAC) with indocyanine green angiography (ICGA) for decision-making in delayed breast reconstruction after nipple-sparing mastectomy (NSM) remains to be fully elucidated. We evaluated patterns of ischaemia and reperfusion in NSM with delayed breast reconstruction, and their outcomes.
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Facial artery myomucosal flap (FAMM) is an intraoral flap pedicled on facial artery used for reconstruction of oral/oropharyngeal defects. Careful assessment of perfusion is essential to avoid flap necrosis, and several options are used for this purpose. Among these, indocyanine green (ICG) fluorescence video-angiography (ICG-VA) represents an innovative tool whose adoption in flap surgery is still at its early days.
In this multimedia article, we described the use of ICG-VA for perfusion assessment of a FAMM flap harvested for reconstruction of oral lining after ablation of a cT2cN0 floor-of-mouth (FOM) cancer. The use of ICG-VA was aimed at defining ischemic areas on the flap according to a flap-to-normal mucosa ICG ratio. Perfusion was documented both with white light modality with “overlay fluorescence” and “black and white SPY fluorescence mode” designed to increase the sensitivity of ICG detection. Small, ischemic areas were detected in the distal part of the flap and were trimmed.
At the end of the procedure, an adequate perfusion was evident throughout the whole flap, allowing its safe insetting for left FOM reconstruction. Postoperative course was uneventful. Conclusions ICG-VA represents a reliable tool for intraoperative detection—and trimming—of ischemic areas on reconstructive flaps.
https://link.springer.com/article/10.1245/s10434-022-12171-2