heal or not, and one of the main reasons is because of ischemia."
Dr. Schlachta says surgeons look at the color of the tissue and the
amount of bleeding that occurs when the bowel is cut. "We do all
these tricks to determine if the bowel is healthy when we put it back
together," he explains. "Now I can just say, 'Give a dose of ICG,' and
that's how I can tell that it's perfused."
Another benefit for Dr. Schlachta? Identifying biliary anatomy. "I had
a case where I was doing a colon resection," he says. "I used the ICG
to determine the viability of the ends of the bowel that I wanted to put
back together for the anastomosis."
In that same case, it was determined the patient also needed their
gallbladder removed, a procedure that was made more difficult
because of very challenging anatomy. Dr. Schlachta switched on the
ICG system to see the biliary structures.
"It worked perfectly," he says. "So we used the technology for bowel
profusion and biliary anatomy in the same case."
Surgeons using near-infrared fluorescence are developing novel
applications, according to Dr. Schlachta, including off-label uses not
currently advocated by system manufacturers.
"Surgeons are saying, 'This is such an awesome technology. What
else can we use it for?'" says Dr. Schlachta, listing applications he's
heard about, including lymph node mapping, gynecological proce-
dures, and surgeries that involve melanoma and identifying the
parathyroid gland.
Near-infrared fluorescence continues to evolve. It's far from a fin-
ished product, but it's definitely a highly functional platform your
surgeons can put to use now. "Great promise, minimal interruption
of the workflow and super-cheap," says Dr. Schlachta. "It's a win-
ning technology. I can tell you in my own hands, it changes the
way I do surgery."
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