Menezes Summer Deah, Rao Tanushree
Obstetrics and Gynaecology Department Liverpool Hospital, Locked Bag 7103 Liverpool 2170, Sydney, NSW, Australia.
University of New South Wales South Western Sydney Clinical School Liverpool Hospital, Level 2, Clinical Building, Locked Bag 7103 Liverpool 2170, Sydney, NSW, Australia.
Case Rep Obstet Gynecol. 2024 Jul 26;2024:1642315. doi: 10.1155/2024/1642315. eCollection 2024.
In the context of increased adoption of minimally invasive surgery for benign gynaecological conditions, this study underscores the paramount importance of patient safety. We explored the efficacy of indocyanine green (ICG), a fluorescent dye, in enhancing the visualisation of critical anatomical structures during complex laparoscopic procedures. Our methods involved the direct administration of ICG into the ureters for precise identification and dissection, as well as an innovative vaginal application to delineate the rectovaginal plane in cases with distorted pelvic anatomy. The study presented two cases: a laparoscopic hysterectomy for a multifibroid uterus and a case of advanced endometriosis with rectal involvement. Results indicated that ICG use significantly improved real-time visualisation of the ureters and the rectovaginal plane, which facilitated the surgeries and reduced the cognitive load on surgeons. There were no intraoperative complications, and the postoperative phase showed positive patient outcomes. In conclusion, the application of ICG in these laparoscopic surgeries proved to be a beneficial adjunct, suggesting its potential for broader application in benign gynaecological surgeries. Future research is warranted to explore additional uses of ICG, with a focus on enhancing patient safety and surgical efficacy.
在越来越多采用微创手术治疗良性妇科疾病的背景下，本研究强调了患者安全的至关重要性。我们探讨了荧光染料吲哚菁绿（ICG）在复杂腹腔镜手术中增强关键解剖结构可视化方面的功效。我们的方法包括将ICG直接注入输尿管以进行精确识别和解剖，以及一种创新的经阴道应用方法，用于在盆腔解剖结构扭曲的病例中勾勒直肠阴道平面。该研究展示了两个病例：一例为多肌瘤子宫的腹腔镜子宫切除术，另一例为累及直肠的晚期子宫内膜异位症。结果表明，使用ICG显著改善了输尿管和直肠阴道平面的实时可视化，这有助于手术进行并减轻了外科医生的认知负担。术中无并发症发生，术后患者情况良好。总之，ICG在这些腹腔镜手术中的应用被证明是一种有益的辅助手段，表明其在良性妇科手术中具有更广泛应用的潜力。有必要进行未来研究以探索ICG的更多用途，重点是提高患者安全性和手术疗效。
