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The Role of Indocyanine Green Fluorescence in Rectal Cancer Robotic Surgery: A Narrative Review

Authors :
Elena Belloni
Edoardo Maria Muttillo
Salomone Di Saverio
Marcello Gasparrini
Antonio Brescia
Giuseppe Nigri
Source :
Cancers, Vol 14, Iss 10, p 2411 (2022)
Publication Year :
2022
Publisher :
MDPI AG, 2022.

Abstract

Background: In rectal cancer surgery, anastomotic leakage (AL) remains the most feared complication, with a frequency of up to 30% in non-high-volume centers. The preservation of proper vascularization is a key factor for successful anastomosis. The use of fluorescence with indocyanine green (ICG) as an intraoperative method to verify optimal perfusion is becoming an interesting tool in rectal surgery. Today, robotic surgery, together with the use of the intraoperative evaluation of the perfusion with ICG, could be a real strategy to deal with AL, allowing for a more delicate and less traumatic surgical technique. This strategy may allow for an extremely accurate surgery, and for optimal control of the proper vascularization of the rectum. Methods: The purpose of this descriptive review is to analyze the impact of fluorescence and robotic surgery on short-term surgical outcomes for rectal cancer. Results: We performed a systematic literature search using the PubMed, Embase and Cochrane library databases. The primary endpoints were to evaluate the application of ICG fluorescence in robotic rectal surgery and the rate of anastomotic leakage when using these technological implementations. The secondary endpoints were to evaluate the dosage of ICG and the timing of application by different surgeons. Conclusions: ICG fluorescence is an inexpensive and quick method to assess bowel perfusion, providing immediate feedback to the surgeon, even if its role has not been proven. A quantitative system must be systematically introduced to minimize the subjectiveness of the visualized image.

Details

Language :
English
ISSN :
20726694
Volume :
14
Issue :
10
Database :
Directory of Open Access Journals
Journal :
Cancers
Publication Type :
Academic Journal
Accession number :
edsdoj.b2a1f157a6d489fb4a9be64d2006ef7
Document Type :
article
Full Text :
https://doi.org/10.3390/cancers14102411