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TheSAGES
Manual
ofFluorescenceGuided Surgery
NovaSzoka· DavidRenton·
SantiagoHorganEditors
123
The SAGES Manual of
Fluorescence-Guided Surgery
Nova Szoka • David Renton
Santiago Horgan
Editors
The SAGES Manual of
Fluorescence-Guided
Surgery
Editors
Nova Szoka
Department of Surgery
West Virginia University
Morgantown, WV, USA
David Renton
Division of General Surgery
Ohio State University
Columbus, OH, USA
Santiago Horgan
Department of Surgery
University of California,
San Diego
San Diego, CA, USA
ISBN 978-3-031-40684-3 ISBN 978-3-031-40685-0 (eBook)
https://doi.org/10.1007/978-3-031-40685-0
© Society of American Gastrointestinal and Endoscopic Surgeons 2023
This work is subject to copyright. All rights are solely and exclusively licensed by
the Publisher, whether the whole or part of the material is concerned, specically
the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting,
reproduction on microlms or in any other physical way, and transmission or
information storage and retrieval, electronic adaptation, computer software, or by
similar or dissimilar methodology now known or hereafter developed.
The use of general descriptive names, registered names, trademarks, service
marks, etc. in this publication does not imply, even in the absence of a specic
statement, that such names are exempt from the relevant protective laws and
regulations and therefore free for general use.
The publisher, the authors, and the editors are safe to assume that the advice and
information in this book are believed to be true and accurate at the date of
publication. Neither the publisher nor the authors or the editors give a warranty,
expressed or implied, with respect to the material contained herein or for any
errors or omissions that may have been made. The publisher remains neutral with
regard to jurisdictional claims in published maps and institutional afliations.
This Springer imprint is published by the registered company Springer Nature
Switzerland AG
The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland
Paper in this product is recyclable.
For my family who is my
https://t.me/medicina_free
foundation and my heart.
-Nova Szoka
Introduction
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Fluorescence-Guided Surgery (FGS), an innovative technology
based on real-time intraoperative image guidance, has been transforming surgical practice in recent years. Currently, the most
popular method of FGS uses a near infrared (NIR) uorescent dye
or a NIR emitting light source to identify anatomic structures, target surgical pathology during surgical procedures, or assess perfusion to an area of interest, thus providing surgeons with objective
information that can enhance both surgical performance and surgical outcomes.
In this book, we will explore the world of FGS, delving into its
history, current applications, and future potential. We will examine the science behind this technique and explore the use of NIR
infrared imaging in multiple surgical specialties, as well as examine novel uorescence agents and modalities. Expert surgeons
from a comprehensive list of surgical subspecialties were enlisted
to share their experience using FGS, and this manual can be used
as a guide for surgeons who are interested in incorporating FGS
into their practice.
The rst two chapters in this manual introduce the history and
science of immunouorescence and provide a comprehensive
review of current uorescence-guided platforms and devices; the
remaining chapters discuss orescence-guided imaging within a
specic surgical subspecialty and include background information, indications for use, a technical description of the procedure(s),
and a review of potential pitfalls. Each of these chapters also
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Introduction
describes the level of evidence for FGS supported by current
publications. Chapter content is augmented by color images and
videos.
Whether you are a surgeon, a medical professional, or simply
someone with an interest in the latest advances in medical technology, this book will provide you with a comprehensive overview of Fluorescence-Guided Surgery, its current applications,
and its exciting potential for the future.
The editors would like to thank the authors who contributed to
this book, who are pioneers within a blossoming eld of surgical
imaging, as well as thank SAGES and Springer for supporting this
work.
Contents
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1 History and Science of Immunofluorescence . . . . . . . 1
Ludovica Baldari, Luigi Boni, and Elisa Cassinotti
2 Current Fluorescence- Guided Platforms and
Devices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Donovan Hui, Kevin Carroll,
Christina Sanders, and David Pechman
3 Use of Fluorescence Guidance in Colorectal
Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87
Michael R. Freund, Anna Duprée, and Steven D. Wexner
4 Use of Fluorescence Guidance
in Cholecystectomy
Ryan C. Broderick, David Renton, and Santiago Horgan
5 Use of Fluorescence Guidance in Hepatic
Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135
Iswanto Sucandy, Emanuel Shapera, and Takeaki Ishizawa
. . . . . . . . . . . . . . . . . . . . . . . . . . . . 123
6 Use of Fluorescence Guidance in Endocrine
Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157
Jared Matson, Thinzar M. Lwin, and Michael Bouvet
7 Use of Fluorescence Guidance in Bariatric
Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 193
Edmund B. Chen, Mark A. Burroughs, Andrea
Trinh, Sachin Kukreja, and Keri A. Seymour
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Contents
8 Use of Fluorescence Guidance in Breast
Reconstruction
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 231
Acara Turner, Luis Quiroga, Sebastian Brooke,
and Kerri Woodberry
9 Use of Fluorescence Guidance in Plastic and
Reconstructive Surgery: Skin and Muscle Flaps . . . . 257
Zachary A. Koenig, Cristiane M. Ueno,
Jack J. Gelman, and Kerri Woodberry
10 Use of Fluorescence Guidance in Burn Surgery . . . . 275
Apinut Wongkietkachorn, Palakorn
Surakunprapha, Supawich Wongkietkachorn,
Sarinya Boonpoapichart, and Phachara Longmeewong
11 Use of Fluorescence Guidance in Acute Care
Surgery and Trauma . . . . . . . . . . . . . . . . . . . . . . . . . . . 307
Elwin Tham, Jennifer Knight, and Nova Szoka
12 Use of Fluorescence Guidance in Pediatric
Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 337
Stefan Scholz, Hannah Rinehardt, Ranjeet S. Kalsi,
Jillian C. Jacobson, and Samir Pandya
13 Use of Fluorescence Guidance in Neurosurgery . . . . 385
Brendan Jones and Maxwell Almenoff
14 Use of Fluorescence Guidance
in Cardiothoracic Surgery . . . . . . . . . . . . . . . . . . . . . . 403
Derek Muehrcke
15 Use of Fluorescence Guidance in Urologic
Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 435
David Zekan, Andrew Williams, Amr Elbakry,
and Adam Luchey
16 Use of Fluorescence Guidance in Gynecology . . . . . . 463
Lioudmila Lipetskaia, Barbara Diane Gillis,
and Courtney Grifths
17 Future Directions in Fluorescence-and
Image- Guided Surgery . . . . . . . . . . . . . . . . . . . . . . . . . 487
Gene Yang
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 501
Contributors
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Maxwell Almenoff, MD Department of Cardiovascular and
Thoracic Surgery, Vascular Surgery, West Virginia University
Heart and Vascular Institute, Morgantown, WV, USA
LudovicaBaldari, MD Department of General and Minimally
Invasive Surgery, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
LuigiBoni, MD Department of General and Minimally Invasive
Surgery, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
Department of Scienze Cliniche e delle Comunità, University of
Milan, Milan, Italy
SarinyaBoonpoapichart, MD Division of Plastic and Reconstructive Surgery, Department of Surgery, Faculty of Medicine,
Khon Kaen University, Khon Kaen, Thailand
Michael Bouvet, MD Department of Surgery, UC San Diego,
San Diego, CA, USA
VA San Diego Healthcare System, San Diego, CA, USA
Ryan C. Broderick, MD Division of Minimally Invasive Surgery, Department of Surgery, University of California San Diego,
La Jolla, CA, USA
Sebastian Brooke, MD Department of Surgery, Division of
Plastic, Reconstructive, and Hand Surgery, West Virginia University School of Medicine, Morgantown, WV, USA
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