Diagnostic Green

📣 Diagnostic Green is now on Bluesky Social! By expanding to Bluesky, we aim to foster new conversations, share valuable insights, and stay at the forefront of healthcare and diagnostic technology discussions when it comes to Verdye & Fluorescence Guided Surgery. 👉 Follow us on Bluesky to stay updated on our latest developments and industry insights. Let’s build a healthier tomorrow, one connection at a time! #blueskysocial #bluesky #connectedconversation #medtech #indocyaninegreen #icflow #verdye #diagnosticgreen https://lnkd.in/efc6NGhs

Preoperative Indocyanine Green Tattooing for Robotic-Assisted Surgery in Rectal Cancer Introduction: Preoperative identification of the site of rectal cancer surgery is crucial for ensuring accurate tumor localization and resection. Commonly employed methods include contrast-enhanced enterography and endoscopic marking techniques, such as clipping and India ink tattooing. However, India ink tattooing poses challenges, including obstruction of the surgical field, ink leakage into the abdominal cavity, and potential complications such as peritonitis and adhesive bowel obstruction. Similarly, clipping requires palpation, making minimally invasive procedures, such as laparoscopic or robotic-assisted surgery, impractical. Materials and surgical technique: The indocyanine green fluorescence method is employed intraoperatively to monitor blood and lymph flow in the intestinal tract. Here, we discuss the effectiveness of preoperative indocyanine green marking in accurately locating tumors during robot-assisted rectal colorectal surgery. Discussion: By using the fluorescence properties of indocyanine green, surgeons can precisely identify the tumor site, overcoming the limitations of traditional methods. This technique improves surgical accuracy while minimizing intraoperative risks and achieving optimal oncological outcomes. Preoperative indocyanine green tattooing represents a valuable enhancement to current techniques in rectal cancer surgery, particularly for robot-assisted approaches. Our findings underscore the applicability of preoperative indocyanine green tattooing as a promising alternative in robot-assisted surgery for patients with rectal cancer. #rectalcancer #rectalcancersurgery #preoperativeindocyaninegreen #indocyaninegreen #icg #verdye #fluorescenceguidedsurgery #diagnosticgreen https://lnkd.in/eKnX7sEh

 Impact of technological advancements on short-term outcomes in flap reconstruction after soft tissue sarcoma resection: A retrospective comparative analysis Background: Soft tissue sarcomas (STS) are rare malignancies requiring extensive surgical resection, often leading to significant soft tissue defects. Flap reconstruction is crucial for restoring function and appearance. Recent reconstructive microsurgery advancements, including high-resolution indocyanine green (ICG) imaging and ultra-high-frequency ultrasonography (UHFU), have revolutionized preoperative planning and intraoperative guidance. We aimed to compare the surgical procedures and short-term outcomes of patients undergoing immediate flap reconstruction before and after our department's adoption of these technologies. Methods: We retrospectively analyzed 276 patients who underwent immediate flap reconstruction postsarcoma resection between May 2014 and December 2023. They were categorized into pre and post-technology groups based on the introduction of ICG angiography and UHFU in July 2019. We collected demographic, surgical, and postoperative data and compared outcomes using Fisher's exact and t-tests. Results: The muscle preservation rate at the donor site was significantly higher in the post-Tech than in the pre-Tech group (no muscle damage: 65% vs. 37%, incision muscle damage: 25% vs. 26%, and muscle resection: 10% vs. 37%; p<0.01). The proportions of complications (21% vs. 36%, p=0.01), flap complications (17% vs. 30%, p=0.01), partial flap loss (5% vs. 17%, p<0.01), and flap dehiscence (9% vs. 25%, p<0.01) were low in the post-Tech group. In the stratified analysis of free-flap reconstruction, the post-Tech group had a shorter operative time (7:01 vs. 8:13, p=0.03) and fewer takebacks due to compromised flap perfusion (4% vs. 15%, p=0.03) compared to the pre-Tech group. Conclusions: The introduction of ICG angiography and UHFU has improved surgical outcomes in STS flap reconstructions. These technologies facilitate precise preoperative planning and intraoperative decision-making, resulting in reduced operative times, low complication rates, and enhanced muscle preservation at the donor site. #flapreconstruction #sarcomaresection #icga #indocyaninegreen #verdye #betterpatientoutcomes #diagnosticgreen https://lnkd.in/dEKNZGpB

Indocyanine green highlights the lymphatic drainage pathways, enhancing the effectiveness of radical surgery for mid-low rectal cancer: A non-randomized controlled prospective study Background: Fluorescence-guided lymphadenectomy (FLND) using indocyanine green (ICG) has emerged as a promising technique to enhance the accuracy of lymphadenectomy in rectal cancer surgery. Effective lymphadenectomy is crucial for improving prognosis in patients with advanced rectal cancer, but it remains technically challenging and controversial. Methods: This prospective nonrandomized controlled study was conducted involving 129 patients underwent laparoscopic surgery, and 64 patients assisted by FLND. Patients received submucosal ICG injections before surgery to facilitate FLND. Lymph nodes were categorized as station 251, station 252, or station 253 based on their anatomical locations. The effectiveness of FLND was evaluated by comparing the number of harvested and metastatic lymph nodes between the FLND and control groups. Results: The FLND group demonstrated a significantly higher median number of harvested station 253 lymph nodes compared to the control group (2.0 vs. 1.0, P = 0.007). The FLND cohort had a shorter postoperative hospital stay (6 days vs. 8 days, P < 0.001) and similar rates of postoperative complications compared to the control cohort. The study found no significant differences in the median number of harvested station 251 (10.0 vs. 11.0, P = 0.872) and station 252 (6.0 vs. 5.0, P = 0.369) lymph nodes between the groups. Univariate and multivariate analyses indicated that FLND significantly increased the harvested lymph node count. Conclusion: Radical surgery assisted by FLND significantly improves the accuracy and yield of lymphadenectomy in mid-low rectal cancer, enhancing surgical outcomes and patient prognosis. Future advancements in fluorescence imaging and related technologies hold promise for further improving the clinical effectiveness of this technique. #fluorescenceguidedlymphadenectomy #flnd #fluorescenceguidedsurgery #fgs #icg #indocyaninegreen #verdye #betterpatientoutcomes #diagnosticgreen https://lnkd.in/dvm9spUj

Axillary Reverse Mapping Using Indocyanine Green in Breast Cancer: Standardization of the Technique Purpose: To validate the Axillary Reverse Mapping (ARM) technique with indocyanine green (ICG), focusing on the detection rate and the procedure's feasibility. The predictive factors for metastatic involvement of ARM nodes are also analyzed to define the target population for ARM indication. Methods: This prospective, observational, non-randomized study of patients with breast cancer included patients with an indication for axillary lymph node dissection (ALND) performed between June 2021 and June 2023. Participants were divided into two cohorts based on pattern of ICG migration: standard technique (all ARM nodes) and targeted technique (in contact with axillary vein). The feasibility of identifying and preserving ARM nodes during ALND was assessed. Multivariate logistic regression was used to analyze predictive factors (eg, tumor size, molecular surrogate subtype, multifocality, and neoadjuvant therapy) for metastatic ARM nodes. Results: Of the 41 patients in whom we performed the ARM technique, ARM nodes were identified and preserved after ALND in 36 patients (87.8%). Of these, 17 (89.5%) underwent the standard technique and 19 (86.4%) underwent the targeted technique. ARM metastases were identified in 12 patients: 9 (47.1%) with the standard technique and 3 (15.7%) with the targeted technique (P = .026). The ARM technique was the only risk factor for ARM involvement (odds ratio, 15.9; 95% confidence interval, 1.1-218.6). Conclusions: ICG facilitates the successful completion of ARM in almost 90% of patients undergoing ALND. In addition, by selecting the ARM nodes closest to the axillary vein, the number of cross metastases can be significantly reduced. #axillaryreversemapping #arm #breastcancer #breastcancercare #icg #indocyaninegreen #verdye #betterpatientoutcomes #diagnosticgreen https://lnkd.in/e_w6NSjQ

Real-Time Fluorescence Imaging for Thoracic Duct Identification during Oesophagectomy: A Systematic Review of the Literature Postoperative chylothorax is a serious complication after oesophagectomy. Real-time identification of the thoracic duct (TD) could prevent injury or facilitate prompt management when it occurs. Intraoperative TD lymphography with indocyanine green (ICG) is a novel technique that may help prevent chyle leaks following thoracic surgery. A systematic search of PubMed, Embase, MEDLINE, Scopus, and the Cochrane Library for studies published until July 2024 evaluating ICG for TD identification during oesophagectomy was performed. Studies were included in the review if they assessed intraoperative TD identification with ICG to prevent chyle leakage in patients undergoing oesophagectomy. Nine of 265 screened papers were included in the present review, with 3 reporting comparative techniques of TD identification between patients. Only 1 study had a control group without ICG administration. TD was identified in 281 of the 303 patients who received ICG. Chyle leak incidence was 0.66% in the ICG group. The mean observation time of TD after ICG administration was 162 minutes. Most of the included patients received neoadjuvant treatment before surgery. Different application routes of ICG have been reported, with the most prominent one being through the inguinal region under ultrasound guidance. Real- time TD identification with ICG might be a valuable tool for avoiding injury or managing it intraoperatively. To our knowledge, this is the first systematic review on this complex topic. However, as no randomized controlled trials have been published, sufficient evidence is needed to determine whether the aforementioned method can sufficiently reduce the chyle leak rate. #tdidentification #thoracicduct #oesophagectomy #fluorescenceimaging #icg #indocyaninegreen #fluorescenceguidedsurgery #verdye #diagnosticgreen https://lnkd.in/eMW98ZiP

📣 ISFGS - International Society for Fluorescence Guided Surgery European Chapter Webinar! January 15 at 15.00 CET. Exciting advancements are shaping the world of pediatric surgery! This webinar is focused on Fluorescence-Guided Surgery Using Indocyanine Green (ICG, Verdye) in children, hosted by the ISFGS - International Society for Fluorescence Guided Surgery. Register here - https://lnkd.in/ddMpXNWG #paediatricsurgery #betterpatientoutcomes #impactofseeingmore #icg #indocyaninegreen #verye #fluorescenceguidedsurgery #fgs #isfgs #diagnosticgreen

Primary Lymphedema: Anatomically Isolated or a Pervasive Systemic Disorder? Background: Primary lymphedema, a condition characterized by impaired lymphatic function, has long remained underexplored. Current diagnostic approaches rely on clinical history and genetic testing, yet the genetic underpinnings remain elusive in many cases. Traditional thinking suggests that primary lymphedema is confined to specific anatomical regions, but our experience challenges this notion. We hypothesize that primary lymphedema is systemic lymphatic dysfunction. Methods: All patients with clinical diagnosis of primary lymphedema from January 2020 to April 2022 were included in our study. Demographic data, medical and surgical history, and indocyanine green (ICG) lymphographic findings were collected. Results: A total of 152 patients met our inclusion criteria. We observed a predominance of female patients (75%) and a mean age of 43.9 years. The onset of swelling varied, with most patients (82.3%) experiencing it in their lower extremities. Notably, ICG lymphography revealed abnormal lymphatic findings in all symptomatic limbs, affecting multiple extremities in 97.4% of patients. Importantly, even among patients initially presenting with limited symptoms, asymptomatic extremities exhibited lymphatic defects. In addition, the extent of lymphatic disease, assessed through ICG lymphography, surpassed clinical symptoms in 80% of cases, underscoring the systemic nature of primary lymphedema. Conclusions: Our study suggests that primary lymphedema is a systemic lymphatic insufficiency, affecting the entire lymphatic system. This underscores the importance of comprehensive assessments, even with limited symptoms, to facilitate earlier diagnosis and more effective treatment approaches. #lymphedema #earlydiagnosis #betterpatientoutcomes #icg #indocyaninegreen #verdye #icglymphaography #diagnosticgreen https://lnkd.in/eAddKhwB

Indocyanine Green Angiography for Real-time Evaluation of Nasoseptal Flap Vascularity and Perfusion Objectives: To investigate the characteristics of the vascular pedicle of the nasoseptal flap (NSF) and its perfusion patterns using intraoperative indocyanine green (ICG) angiography during endoscopic skull base surgery (ESBS), and examine the correlation between ICG perfusion patterns and clinical outcomes, including postoperative cerebrospinal fluid (CSF) leak and flap necrosis. Methods: This study enrolled patients undergoing ESBS between January 2017 and December 2021. Intraoperative ICG angiography was performed to visualize the arterial supply of the nasal septum and evaluate NSF perfusion. Postoperative CT scans and clinical follow-ups were conducted to assess flap outcomes. Results: A total of 126 patients were included in the study. The posterior septal artery (PSA) was most commonly identified in the middle third of the sphenoidal rostrum (63.5% right, 60.3% left). Three branching patterns were observed: single-branch (58.7% right, 64.3% left), double-branch (12.7% right, 11.1% left), and reticular-branch (26.6% right, 24.6% left). Among 72 patients who underwent NSF placement, ICG angiography showed full enhancement in 37 patients (51.4%), partial enhancement in 27 patients (37.5%), and no enhancement in eight patients (11.1%). Postoperative CSF leak occurred in eight patients (11.1%), with no significant correlation to ICG enhancement patterns (p = 0.07). Flap necrosis occurred in five patients (6.9%), all of whom had shown no ICG enhancement beyond the pedicle (p < 0.01). Conclusions: ICG angiography is a valuable tool for visualizing the vascular supply of NSF during ESBS. While it does not correlate with postoperative CSF leak, ICG enhancement pattern showed a significant association with flap necrosis. This technique may contribute to improved surgical outcomes and reduced complications in NSF reconstructions. #nasoseptalflap #vascularity #perfusion #perfusionassessement #icga #vascularbloodsupply #indocyaninegreen #icg #verdye #improvedsurgicaloutcomes #betterpatientoutcomes #diagnosticgreen https://lnkd.in/eTVGeBJw

Indocyanine Green Lymphography in Conservative Lymphedema Management: An Exploration of the Impact on Lymphedema Therapy Plans Objectives: Information from indocyanine green (ICG) lymphography (ICG-L) can be used to guide an individual's lymphedema therapy plan. However, the mechanisms for this clinical translation are not well described. This study proposes a novel clinical decision support tool for translating ICG-L findings into individualized lymphedema therapy plans and describes subsequent changes in plan features of manual lymphatic drainage and compression. Methods: This before-after study compared specific therapy plan features before and after ICG-L for participants with limb lymphedema. After participants had undergone ICG-L, the individuals' ICG-L findings were translated into an ICG-L-informed therapy plan using a novel clinical decision support tool, ICG-TRANSLATE. A predetermined coding tree was used to identify changes in elements of manual lymphatic drainage and compression therapy plan recommendations. Results: Following the application of the ICG-TRANSLATE decision support tool, 100% (n = 25) of participants had a change in manual lymphatic drainage recommendations, including elements of terminal nodes, pathway, and technique. Additionally, 88% (n = 22) had a change in compression recommendations, which was most commonly a change in garment limb coverage. Conclusions: ICG-L findings informed changes to traditional lymphedema therapy plan modalities of manual lymphatic drainage and compression. Whether this change to individual therapy recommendations translates into improved lymphedema outcomes requires further investigation. Implications for nursing practice: A clinical decision support tool may assist practitioners in translating ICG-L findings into individualized lymphedema therapy plans for people with lymphedema. Further exploration is necessary to determine if the management changes derived through ICG-L-informed therapy plans improve outcomes for people with lymphedema. #icgl #lymphedema #lymphedemaprevention #icg #indocyaninegreen #verdye #impactofseeingmore #betterpatientoutcomes #diagnosticgreen https://lnkd.in/eFHNpkVt