Question

ICG (Indocyanine Green) in surgical gastroenterology:
Enumerate the principles and uses of ICG in surgical gastroenterology procedures.

Hint:

ICG is a powerful tool in surgical gastroenterology, aiding in real-time visualization of tissues and organs, improving surgical precision, and reducing the risk of complications.

Answer 1

Indocyanine Green (ICG) is a fluorescent dye used in various medical imaging techniques, including surgical gastroenterology. Its fluorescence properties allow for real-time imaging during surgeries, making it an essential tool in modern surgical practices.
Step 1: Principles of ICG in Surgical Gastroenterology:
- Fluorescence Emission: ICG absorbs infrared light (near-infrared light) and emits fluorescence, which can be detected using specialized cameras. This property allows surgeons to visualize structures that are otherwise difficult to assess with conventional methods.
- Safe and Non-Toxic: ICG is well-tolerated by the body, with minimal toxicity. It is rapidly cleared from the bloodstream by the liver, making it suitable for use in liver and gastrointestinal surgeries.
- Real-time Imaging: The ability to observe fluorescence in real time during surgery aids in the precise visualization of tissues, vessels, and other anatomical structures, improving the accuracy of surgical interventions.
Step 2: Uses of ICG in Surgical Gastroenterology:
- Liver Surgery: ICG is widely used to assess liver function and perfusion during hepatectomies or liver transplants. It helps in identifying vital blood vessels and assessing the viability of liver tissue.
- Biliary Surgery: During surgeries involving the bile ducts, such as cholecystectomy, ICG can be used to visualize the biliary system and bile flow, helping avoid bile duct injuries.
- Colorectal Surgery: ICG can be used to assess blood flow and viability of tissue during colorectal surgeries, such as resection of colorectal cancer or diverticulitis. It helps in identifying areas at risk of necrosis and ensuring adequate perfusion of the bowel.
- Anastomotic Assessment: After anastomosis, ICG is used to evaluate the blood flow to the newly joined tissues, ensuring the success of the surgical connection and reducing the risk of leakage or complications.