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Indocyanine Green (ICG) Fluorescence-Guided Surgery

Advanced intraoperative technique that uses near-infrared light to visualize tissue perfusion and anatomy in real time.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Genel Cerrahi department. Book Appointment →

What is Indocyanine Green (ICG) Fluorescence-Guided Surgery?

Indocyanine green (ICG) is a water-soluble dye that fluoresces under near-infrared light at 800 nm when injected intravascularly. Specialized cameras then visualize vessels, lymphatic channels, and tissue perfusion in real time.

Applications include assessment of colorectal anastomotic perfusion, intraoperative biliary anatomy (cholangiography), sentinel lymph node mapping, hepatic segment delineation, and tumor identification. It has transformed laparoscopic and robotic surgery.

The method reduces anastomotic leak by up to 40 percent, lowers bile duct injury risk, and supports oncological margin definition. It has a high safety profile with low allergic risk.

Symptoms

Low anterior resection anastomosis assessment
Biliary anatomy during laparoscopic cholecystectomy
Liver segment delineation
Sentinel lymph node mapping (breast, melanoma, colon)
Esophagectomy anastomotic perfusion
Gastric remnant perfusion in gastrectomy
Flap viability in plastic surgery
Demarcation of liver and pancreatic tumors

Risk Factors

Iodine allergy and rare ICG allergy
Severe thyroid dysfunction
Pregnancy as a relative contraindication
Cost of dedicated equipment
Surgeon learning curve
Dosing and timing issues
Hepatic insufficiency with reduced biliary excretion
Hyperthyroidism

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Allergic reaction after injection — pruritus or hypotension
  • Bronchospasm or respiratory distress
  • Skin rash
  • Signs of anastomotic leak
  • Surgical site infection
  • Postoperative jaundice

Treatment Methods

01
Preoperative allergy and thyroid assessment
02
ICG dosing — 0.2 to 0.5 mg per kg intravenously
03
Use of laparoscope or robotic system equipped with NIR camera
04
Injection followed by 30 to 60 seconds of waiting
05
Real-time perfusion evaluation
06
Decision on anastomotic site or resection margin
07
Extension of resection if perfusion is inadequate
08
Documentation of findings in the operative report

Which Department to Visit?

You can visit our Genel Cerrahi department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.