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EP450 The use of indocyanine green in gynae-oncology, beyond sentinel pelvic lymph nodes
  1. M Graham1,
  2. E Craig1,
  3. I Harley1,
  4. A Armstrong2,
  5. S Dobbs1 and
  6. H Nagar1
  1. 1Gynae Oncology
  2. 2General Surgery, Belfast City Hospital, Belfast, UK


Introduction/Background Indocyanine Green (ICG) is a fluorescent imaging agent which can be given intravenously or subcutaneously and detected using near-infrared light at laparoscopy. It can be injected para-cervically in order to identify pelvic sentinel nodes at laparoscopy. It can also be given intravenously in order to test tissue perfusion.

Methodology In this study we have reviewed the use of this technology beyond pelvic sentinel nodes. We have identified four interesting cases for discussion.

Case 1 - A total laparoscopic Hudson's, pelvic and para-aortic node dissection, omentectomy with re-anastomosis and loop ileostomy was performed for endometrioid adenocarcinoma detected during prior excision of endometrioma. Following this procedure intravenous ICG was used to test perfusion at the bowel anastomosis.

Case 2 - A total Laparoscopic hysterectomy was performed for Stage 1A endometrial cancer in a patient with a previous renal transplant. Following the procedure intravenous ICG was used to test perfusion to the transplanted kidney.

Case 3 - A Laparoscopic trachelectomy and pelvic node dissection was performed for 1B cervical cancer with incomplete margins. Following this procedure intravenous ICG was used to test uterine perfusion.

Case 4 - Open groin node dissection was performed on a patient with a squamous vulval cancer. Using the technology in the open setting, following subcutaneous injection of ICG around the tumor we were able to identify the sentinel groin node.

Results We will show edited operative video of all cases mentioned above.

Conclusion ICG technology has been shown to be a useful adjunct when performing sentinel node sampling. Through this presentation we have discussed a number of other interesting applications in the field of gynae-oncology.

Disclosure Nothing to disclose.

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