Let's say you remove
a segment of the
colon. Before reat-
taching the remaining
ends, you can use
immunofluorescence
to check real-time
blood flow to the area
and use that informa-
tion to decide if it's
best to reattach the
ends or reset to
another area with a stronger blood supply.
Dr. Pryor: ICG immunofluorescence is helpful for tough lap choles.
There's been a big push to improve the safety of those procedures —
SAGES has put together a task force to address the issue and empha-
sized the problem during educational sessions at last year's annual
meeting. When you look at the data, most surgeons don't perform a
cholangiogram, instead opting for a critical view dissection, which is
typically safe and adequate. But using ICG visualization to see the
common duct without dissecting would add another level of security
to the procedure and help prevent avoidable patient harm.
We've performed cholangiograms for injury prevention in the past.
Surgeons have avoided it in recent years because it adds time to pro-
cedures and has its own potential for injury. They're therefore not as
well trained in the technique as they once were and aren't comfort-
able performing it. ICG imaging may therefore help bridge the gaps in
their abilities to perform difficult lap choles. The imaging is also use-
ful during difficult cases such as esophagogastrectomy, revisional
9 0 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • J A N U A R Y 2 0 1 6
• ROOM WITH A VIEW The opportunity to work with the best possible imaging technology will attract forward-thinking
and safety-minded surgeons.
Pamela
Bevelhymer,
RN,
BSN
