The utility and safety of Indocyanine green fluorescence imaging in minimally invasive pediatric surgery: a retrospective case series [Oral presentation]

Abstract

<p><b>Background:</b> Indocyanine green (ICG) fluorescence imaging offers real-time, radiation-free intraoperative navigation. Its standardized application in pediatric surgery, including optimal dosing, timing, and administration routes for various conditions, remains under investigation. Our unit has been utilizing ICG in our practice for the past 10 years and in this review, we will describe the current use and potential applications of ICG in pediatric surgery, based on our experience and others in the literature. <br></p><p><b>Methods:</b> A retrospective analysis was conducted on pediatric patients who underwent ICGassisted minimally invasive surgery. Data included demographics, surgical procedure, ICG administration details (route, dose, timing), imaging efficacy, impact on surgical decisionmaking, and adverse events. <br></p><p><b>Results:</b> Difference cases were reviewed, encompassing Hirschsprung's disease, biliary atresia, congenital urogenital anomalies, liver tumors, and pulmonary cystic diseases. Intravenous ICG successfully delineated the transition zone in Hirschsprung's, confirmed anastomotic perfusion in esophageal atresia, defined liver tumor boundaries, and assessed residual liver perfusion. Perfusion via natural orifices effectively defined lung segmental planes and identified ureters during complex pelvic surgery. <br></p><p><b>Conclusion:</b> ICG fluorescence imaging is a safe and highly versatile adjunct that enhances surgical precision and safety across multiple pediatric surgical subspecialties. Optimizing administration routes and dosing protocols can provide critical real-time feedback on tissue perfusion, anatomical delineation, and resection margins, potentially improving outcomes and reducing iatrogenic injury.<br></p>