Indocyanine green in gynecological surgery

Indocyanine green (ICG) is a complex amphiphilic, tricarbocyanine iodide dye initially developed during World War II for infrared photography. It was tested and FDA approved for use in human medicine in the mid-fifties. When injected intravenously and revealed by near infrared light (NIR), ICG can highlight vascularization. ICG-NIR has emerged as an efficient technology, valuably implemented intraoperatively in many gynecological surgeries. Although additional data are needed to optimize protocols, it already stands as an excellent diagnostic and screening tool, which may advantageously replace some established methods, especially for perfusion monitoring and sentinel lymph node mapping. In endometriosis detection, ICG-NIR maps deep infiltrating occult lesions more efficiently than current white light (WL) does. Yet ICG-NIR seems to show lower sensitivity for detecting peritoneal superficial nodules, which suggests that WL and ICG-NIR should be used jointly to achieve optimal intraoperative endometriosis nodule detection.