FF001/#573 Near-infrared angiography for assessment of rectosigmoid anastomoses in gynecologic surgery. (4th December 2022)

• Record Type: Journal Article
• Authors: Sia, Tiffany; Zivanovic, Oliver; Aviki, Emeline
• Is Part Of: International journal of gynecological cancer. Volume 32(2022)Supplement 3
• Page Start: A244
• Page End: A244
• Publication Date: 2022-12-04
• Subjects: Generative organs, Female -- Cancer -- Periodicals; 616.99465
• DOI: 10.1136/ijgc-2022-igcs.553
• Languages: English
• ISSNs: 1048-891X

Abstract

Abstract : Introduction: Rectosigmoid resections are frequently needed to achieve complete disease clearance during surgery for ovarian cancer. A severe complication from rectosigmoid resections is anastomotic leakage. Near infrared angiography (NIR) has been introduced to assess perfusion of vascular pedicles. Given the interest in usage of NIR to evaluate perfusion during rectosigmoid anastomoses, we have put together an instructional video demonstrating the setup and usage of this technology. Description: Intraoperative setup for NIR will require a PINPOINT endoscopic fluorescence imaging system including a 10 mm laparoscope, a PINPOINT rigid scope introducer, and 25 mg of indocyanine green (ICG) dye. After the segment of colon with disease is isolated and divided, perfusion is tested in the proximal limb by injecting 5 mL of the reconstituted ICG intravenously, allowing one minute for the dye to mobilize, and visualizing the bowel with the 10 mm laparoscope. A perfusion defect is identified, and the decision is made to further resect the segment of bowel without perfusion. After this step, the trimmed proximal limb is brought down to the pelvis and anastomosed with the distal limb. Perfusion is tested after anastomosis by bringing placing the PINPOINT rigid scope introducer over the 10 mm laparoscope and introducing the scope through the anus until the anastomotic ring is identified. 5 mL of ICG is reinjected. Perfusion is tested again and found to be adequate. Conclusion/Implications: Assessment of rectosigmoid anastomoses performed for gynecologic surgery using NIR with ICG is feasible, can be performed without the need for numerous additional instruments.