Indocyanine Green Dye as Surgeon’s Intraoperative Armamentarium for Assessing Gastric Conduit Perfusion

Video Descrption As we know, post-esophagectomy anastomotic complications (5–20%) are feared, and poor perfusion is a surgically modifiable factor. However, a suitable, noninvasive, conveniently accessible, cost-effective, objective, and reproducible approach to assessing the viability of the anastomotic site is lacking. In this video, we demonstrate real-time fluorescence angiography using green indocyanine to evaluate the perfusion of the gastric conduit and decide the ideal site for anastomosis. We demonstrated fluorescence angiography qualitatively using different modes of ICG cameras and quantitatively with perfusion assessment ratios. With this video, I want to convey that ICG can be the Surgeon’s Intraoperative Armamentarium and that the technique is non-invasive, real-time, easy, convenient, safe and reproducible. If, with its use, the anastomotic leak rates can be decreased overall, thus reducing morbidity and cost-effectiveness with a one-time investment.