Multicentre phase II trial of near-infrared imaging in elective colorectal surgery

Figure 1. Near‐infrared (NIR) assessment of level of transection. Images of a planned transection before indocyanine green (ICG) injection (arrow) and b visible transection area after ICG injection (arrow) are shown in normal view, NIR view and enhanced reality view. There is no change in transection area if the perfusion signal reaches the planned area for transection

Figure 2. Near‐infrared (NIR) perfusion assessment after a side‐to‐end colorectal anastomosis had been constructed. Intraoperative images of the anastomosis a before and b after indocyanine green (ICG) injection are shown in normal view, NIR view and enhanced reality view. After ICG injection, there was a good signal on the rectal stump and colon

Figure 3. Near‐infrared (NIR) perfusion assessment with change of plan owing to a lack of perfusion at the level of the section originally planned. Intraoperative images are shown in normal view, NIR view and enhanced reality view. a Image before indocyanine green (ICG) injection showing the planned area for proximal transection (yellow arrow) in a segment of descending colon after its mobilization (including high vascular ligation) and mesocolic preparation. b After ICG injection, a clear demarcation line appeared (white arrow) that was 4 cm more proximal (vertical yellow arrow on the initial transection area) and led to more proximal transection (horizontal arrow shows distance that has been assessed as well perfused) being undertaken. c A second injection of ICG in the same patient showed satisfactory perfusion of the constructed colorectal anastomosis in situ