Indocyanine Green Fluorescence Imaging in the Surgical Management of an Iatrogenic Lymphatic Fistula: Description of a Surgical Technique

J Minim Invasive Gynecol. Nov-Dec 2015;22(7):1304-6. doi: 10.1016/j.jmig.2015.06.014. Epub 2015 Jun 27.

Abstract

We present a case of laparoscopic surgical management of an iatrogenic lymphorrhea using indocyanine green (ICG). A case of a patient who developed recurrent symptomatic lymphorrhea after laparoscopic radical hysterectomy and bilateral pelvic lymphadenectomy for an early stage cervical cancer is presented. Intraoperative bipedal interdigital subcutaneous injection of ICG exactly localized the disrupted lymphatic duct on fluorescence imaging performed with a near-infrared laparoscopic fluorescent optic device, thus allowing a successful surgical repair.

Keywords: Indocyanine green fluorescence; Laparoscopy; Lymphorrhea.

Publication types

  • Case Reports

MeSH terms

  • Coloring Agents
  • Diagnostic Imaging
  • Female
  • Fistula / diagnosis*
  • Fistula / surgery
  • Humans
  • Hysterectomy / adverse effects*
  • Iatrogenic Disease*
  • Indocyanine Green
  • Laparoscopy / adverse effects*
  • Lymph Node Excision / adverse effects*
  • Lymphatic Diseases / diagnosis*
  • Lymphatic Diseases / surgery
  • Middle Aged
  • Treatment Outcome
  • Uterine Cervical Neoplasms / surgery*

Substances

  • Coloring Agents
  • Indocyanine Green