REAL-TIME DYNAMIC IMAGE OVERLAY WITH INDOCYANINE GREEN (ICG) IN LAPAROSCOPIC CHOLECYSTECTOMY anaixacur@gmail.com

292-03

REAL-TIME DYNAMIC IMAGE OVERLAY WITH INDOCYANINE GREEN (ICG) IN LAPAROSCOPIC CHOLECYSTECTOMY

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Mexico

Video

Indocyanine green (ICG) is a cyanine dye that fluoresces under near-infrared light. Initially applied in ophthalmology, its use has expanded to multiple surgical specialties, including gallbladder and biliary tract surgery. When administered intravenously, ICG enables—depending on the latency period—the identification of vascular and biliary structures within Calot’s triangle, allowing real-time dynamic image overlay during surgery. Using optical systems with specific filters, surgeons can visualize vascular structures, anatomical planes in monochromatic mode, and biliary drainage pathways, as well as detect anatomical variations of the biliary tree.

An illustrative video of a laparoscopic cholecystectomy using ICG for real-time image overlay is presented, demonstrating progressive identification of biliary and vascular structures during dissection.

ICG-assisted overlay enabled clear visualization of the cystic duct and common bile duct, facilitating Strasberg’s critical view of safety and improving dissection precision. Further prospective studies are required to define its role in routine versus selected cases.

ICG with dynamic overlay optimizes anatomical identification, enhances surgical safety, and may reduce operative times by enabling earlier recognition of critical structures. This technology should be used as an adjunct, not a substitute for conventional methods such as intraoperative transcystic cholangiography, particularly in patients meeting ASGE criteria for suspected choledocholithiasis.

https://vimeo.com/1115477074/e4ac8b8da4