The Use of Indocyanine Green in Colorectal Surgery

Abstract

This chapter looks at the use of indocyanine green (ICG) in colorectal surgery, by exploring at first the definition of vital dyes generally used in the surgical field, afterward the benefits of fluorescence-guided surgery, and furthermore, it enumerates several uses of ICG in the broad surgical field. The identification of tumor nodules in the peritoneum can help with proper cancer staging, and the same advantage is brought by the accurate detection of the sentinel lymph node, which concerns the use of ICG specifically in colorectal surgery, and this can be summed up through the following assets brought by the technique: (a) intraoperative fluorescence angiography as an adjuvant in the process of anastomosis, (b) fluorescence-guided detection of lymph node metastases in colorectal cancer and the sentinel lymph node technique, which was proved better than formal methods in some studies, (c) the positive fluorescence of a liver nodule as small as “only” 200 tumor cells, (d) the help in diagnosing a fistula, (e) the possibility to be used for tumor tattooing also, and (f) the help in maintaining a clean surgical field and preventing wound infection in abdominoperineal resection.