Author/Authors :
osseis, michael henri mondor hospital - department of hepatobiliary, pancreatic surgery and liver transplantation, Créteil, france , lim, chetana henri mondor hospital - department of hepatobiliary, pancreatic surgery and liver transplantation, Créteil, france , lim, chetana inserm (french national institute of health and medical research), Paris, France , moussallem, toufic henri mondor hospital - department of hepatobiliary, pancreatic surgery and liver transplantation, Créteil, france , osseis, mario henri mondor hospital - department of hepatobiliary, pancreatic surgery and liver transplantation, Créteil, france , lahat, eylon henri mondor hospital - department of hepatobiliary, pancreatic surgery and liver transplantation, Créteil, france , salloum, chady henri mondor hospital - department of hepatobiliary, pancreatic surgery and liver transplantation, Créteil, France , azoulay, daniel henri mondor hospital - department of hepatobiliary, pancreatic surgery and liver transplantation, Créteil, France , azoulay, daniel inserm (french national institute of health and medical research), Créteil, France
Abstract :
Introduction : Adequate tissue perfusion is essential in bowel surgery. This article presents three clinical situations illustrating the usefulness of fluorescence-guided surgery in evaluating bowel perfusion. Method: Fluorescence angiography using indocyanine green (ICG) was performed in three patients with ischemic bowel obstruction to determine the feasibility of indocyanine greenfluorescent imaging for detecting ischemic areas. Results : In two patients with acute small bowel obstruction, this technique clearly identified the limits between ischemic tissues and vascularized zones. Ischemic tissues are not visible in fluorescence while in the vascularized regions; the fluorescent imaging system can adequately visualize the mesenteric arteries and veins, and the marginal arteries within the intestinal wall. In the third patient who had a stage II ischemic colitis, fluorescence angiography showed that there was blood supply to the affected bowel, as compared to normal bowel. Conclusion : These case series show that ICG-fluorescent imaging is a simple and feasible technique that can be used to allow assessment of bowel wall perfusion.
NaturalLanguageKeyword :
indocyanine fluorescent imaging , intestinal viability , bowel perfusion , intraoperative assessment , emergency surgery
