The Use of near Infra-Red Radiation Imaging after Injection of Indocyanine Green (NIR–ICG) during Laparoscopic Treatment of Benign Gynecologic Conditions: Towards Minimalized Surgery. A Systematic Review of Literature
Antonio Raffone,
Diego Raimondo,
Alessia Oliviero,
Arianna Raspollini,
Antonio Travaglino,
Marco Torella,
Gaetano Riemma,
Marco La Verde,
Pasquale De Franciscis,
Paolo Casadio,
Renato Seracchioli,
Antonio Mollo
Affiliations
Antonio Raffone
Department of Medical and Surgical Sciences (DIMEC), Univertity of Bologna, 40138 Bologna, Italy
Diego Raimondo
Division of Gynaecology and Human Reproduction Physiopathology, IRCCS Azienda Ospedaliera-Universitaria di Bologna, 40138 Bologna, Italy
Alessia Oliviero
Gynecology and Obstetrics Unit, Department of Medicine, Surgery and Dentistry Schola Medica Salernitana, University of Salerno, 84081 Baronissi, Italy
Arianna Raspollini
Department of Medical and Surgical Sciences (DIMEC), Univertity of Bologna, 40138 Bologna, Italy
Antonio Travaglino
Unità di Ginecopatologia e Patologia Mammaria, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
Marco Torella
Obstetrics and Gynecology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, 80128 Naples, Italy
Gaetano Riemma
Obstetrics and Gynecology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, 80128 Naples, Italy
Marco La Verde
Obstetrics and Gynecology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, 80128 Naples, Italy
Pasquale De Franciscis
Obstetrics and Gynecology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, 80128 Naples, Italy
Paolo Casadio
Division of Gynaecology and Human Reproduction Physiopathology, IRCCS Azienda Ospedaliera-Universitaria di Bologna, 40138 Bologna, Italy
Renato Seracchioli
Department of Medical and Surgical Sciences (DIMEC), Univertity of Bologna, 40138 Bologna, Italy
Antonio Mollo
Gynecology and Obstetrics Unit, Department of Medicine, Surgery and Dentistry Schola Medica Salernitana, University of Salerno, 84081 Baronissi, Italy
Background and Objectives: To assess the use of near infrared radiation imaging after injection of indocyanine green (NIR–ICG) during laparoscopic treatment of benign gynecologic conditions. Materials and Methods: A systematic review of the literature was performed searching 7 electronic databases from their inception to March 2022 for all studies which assessed the use of NIR–ICG during laparoscopic treatment of benign gynecological conditions. Results: 16 studies (1 randomized within subject clinical trial and 15 observational studies) with 416 women were included. Thirteen studies assessed patients with endometriosis, and 3 studies assessed non-endometriosis patients. In endometriosis patients, NIR–ICG use appeared to be a safe tool for improving the visualization of endometriotic lesions and ureters, the surgical decision-making process with the assessment of ureteral perfusion after conservative surgery and the intraoperative assessment of bowel perfusion during recto-sigmoid endometriosis nodule surgery. In non-endometriosis patients, NIR–ICG use appeared to be a safe tool for evaluating vascular perfusion of the vaginal cuff during total laparoscopic hysterectomy (TLH) and robotic-assisted total laparoscopic hysterectomy (RATLH), and intraoperative assessment of ovarian perfusion in adnexal torsion. Conclusions: NIR–ICG appeared to be a useful tool for enhancing laparoscopic treatment of some benign gynecologic conditions and for moving from minimally invasive surgery to minimalized surgery. In particular, it might improve treatment of endometriosis (with particular regard to deep infiltrating endometriosis), benign diseases requiring TLH and RATLH and adnexal torsion. However, although preliminary findings appear promising, further investigation with well-designed larger studies is needed.
