FCV-278 50 shades of green

Indocyanine green (ICG) is a type of fluorescent dye which, under specific near infrared fluorophores, emits a green fluorescence during laparoscopy. Historically used primarily to identify sentinel lymph nodes during gynae-oncology surgery, its use is becoming increasingly popular in many “benign’ gynaecological surgeries and for some it has become a routine adjunct to many surgical procedures. 

In this video we detail its many uses in gynaecology, highlighting potential surgical benefits including:

Ureteric identification - injecting dilute ICG via ureteric catheters to aid ureteric visualisation. This can be helpful in simple cases to aid ureteric visualisation and complex cases aiding retroperitoneal dissection and ureterolysis.

Identification of the endometrial cavity during myomectomy - use of ICG instilled into the uterine cavity allows better identification of the endometrial cavity, careful dissection during myomectomy and reduces inadvertent cavity breaches.

Demarcating bladder and assessing for injury - helpful adjunct to identify bladder margins to aid difficult dissections in cases of multiple caesarean sections.

Fallopian tube dye test - using ICG as an alternative to methylene blue allows the dye test to be done at the beginning of the procedure without the concerns for unwanted blue staining of the pelvis and avoids false negatives due to tubal spasm.