Our Summary

After colorectal surgery, a complication known as anastomotic leak (AL) can occur, where a connection made during surgery leaks fluid. This can be caused by poor blood flow in the bowel. Traditionally, surgeons gauge blood flow based on their own judgment, but this can be subjective. Fluorescence imaging (FI) with a chemical called indocyanine green (ICG) can help doctors view blood flow in real time, providing a more accurate picture.

A review of past studies found that using FI could change the surgical plan in many cases, potentially reducing the rate of AL. However, the impact on AL rates varied between studies – two showed reductions of 4% and 12% respectively, while another found no significant change. The results suggest that FI is a useful tool in colorectal surgery, and could potentially help lower the risk of complications.

FAQs

  1. What is anastomotic leak (AL) that can occur after colorectal surgery?
  2. How can Fluorescence Imaging (FI) with indocyanine green (ICG) help in colorectal surgeries?
  3. What impact does the use of FI have on the rates of AL according to the review of past studies?

Doctor’s Tip

Therefore, it is important for patients undergoing colorectal surgery to discuss the use of fluorescence imaging with their surgeon. This technology can help improve the outcome of the surgery and reduce the risk of complications such as anastomotic leaks. It is always important to be informed and proactive in your healthcare decisions.

Suitable For

Patients who are typically recommended colorectal surgery include those with conditions such as colorectal cancer, inflammatory bowel disease, diverticulitis, and colorectal polyps. Additionally, patients with severe hemorrhoids or fecal incontinence may also be candidates for colorectal surgery.

Patients who are at a higher risk for complications during or after surgery, such as older adults or those with multiple comorbidities, may benefit from the use of fluorescence imaging with ICG to help reduce the risk of anastomotic leak. By providing real-time visualization of blood flow, FI can help surgeons make more informed decisions during the procedure, potentially leading to better outcomes for these higher-risk patients.

Overall, the use of FI with ICG in colorectal surgery has the potential to improve surgical outcomes and reduce the risk of complications, particularly in patients who may be at a higher risk for anastomotic leaks. It is important for surgeons to consider the benefits of this technology and incorporate it into their practice to improve patient care.

Timeline

  • Before colorectal surgery:
  1. Patient undergoes pre-operative consultations and tests to determine the need for surgery and assess overall health.
  2. Surgery is scheduled and patient receives instructions on how to prepare, such as fasting and bowel cleansing.
  3. Patient undergoes colorectal surgery, which may involve removing part of the colon or rectum.
  4. After surgery, patient is closely monitored in the hospital for complications such as infection, bleeding, or anastomotic leak.
  • After colorectal surgery:
  1. Patient may experience pain, fatigue, and difficulty with bowel movements following surgery.
  2. Surgeon monitors patient’s recovery and may order imaging tests to check for complications.
  3. If an anastomotic leak occurs, patient may experience symptoms such as fever, increased heart rate, abdominal pain, and fluid leakage from the surgical site.
  4. Surgeon may use fluorescence imaging with indocyanine green to assess blood flow in the bowel and potentially prevent or manage anastomotic leaks.
  5. With proper treatment and monitoring, patient recovers from surgery and is able to resume normal activities.

What to Ask Your Doctor

Some questions a patient should ask their doctor about colorectal surgery include:

  1. Can fluorescence imaging with indocyanine green be used during my surgery to assess blood flow and potentially reduce the risk of complications like anastomotic leak?
  2. How will the use of fluorescence imaging affect my surgical plan and recovery process?
  3. What are the potential benefits and risks of using fluorescence imaging during colorectal surgery?
  4. Are there any alternative methods or technologies that could be used to assess blood flow during surgery?
  5. How experienced is the surgical team in using fluorescence imaging for colorectal surgeries?
  6. What is the success rate of using fluorescence imaging to prevent complications like anastomotic leak in colorectal surgery?
  7. How will the use of fluorescence imaging impact the overall outcome of my surgery and my long-term health?
  8. Are there any additional costs associated with using fluorescence imaging during my surgery?
  9. How will I be informed about the results of the fluorescence imaging during my surgery?
  10. Are there any specific pre-operative or post-operative instructions I should follow if fluorescence imaging is being used during my surgery?

Reference

Authors: Mizrahi I, Wexner SD. Journal: Expert Rev Med Devices. 2017 Jan;14(1):75-82. doi: 10.1080/17434440.2017.1265444. Epub 2016 Dec 5. PMID: 27899040