your technique tremendously, as
opposed to the single-incision
approach. Many people feel it's an
easy adoption from laparoscopy."
There are challenges, such as
infusing extremely thin instruments
with adequate strength, but manu-
facturers seem to be overcoming the
strength issue with newer materials
and different configurations.
"I don't use it for patients who are
already going to be a difficult sur-
gery, because it adds an additional
level of complexity," says Dr. Pryor.
"But with a generally straightfor-
ward case, you have more room to
add another level of complexity and still make it a very reasonable
procedure. And if you need to convert to standard lap, just add some
standard size trocars. It doesn't have a major impact on the case."
3
Indocyanine green (ICG)
Indocyanine green is an injectable fluorescent dye that binds
tightly to plasma proteins, providing a kind of internal road
map that lasts a few minutes before it's removed by the liver. It's mar-
keted as ICG-Pulsion (Dynamic Diagnostics) and IC-Green (Akorn).
When combined with improving visualization technology, ICG gives
surgeons a great view in real time, says Dmitry Oleynikov, MD, FACS,
a professor of surgery and director of minimally invasive and robotic
surgery at the Center for Advanced Surgical Technology at the
Nebraska Medical Center in Omaha. "It gives you the anatomy behind
9 0
O U T P A T I E N T S U R G E R Y M A G A Z I N E O N L I N E | N O V E M B E R 2 0 1 5
z BETTER VIEW Indocyanine green provides an
internal road map that augments reality and
improves safety.
