Evolving applications of fluorescence guided surgery in pediatric surgical oncology: A practical guide for surgeons

Fluorescence-guided surgery (FGS) is an increasingly available and popular method of visual field augmentation. The basic premise of FGS entails injection of fluorescent indocyanine green (ICG) and subsequent detection with a near-infrared (NIR) camera. For pediatric surgical oncologists, FGS remains experimental but is a promising modality for identifying tumor margins, locating metastases, performing sentinel lymph node biopsies, protecting peritumoral structures of interest, and facilitating reconstruction. Familiarity with basic ICG pharmacokinetics and NIR detection optics is critical for surgeons wishing to judiciously use FGS, as its success is firmly grounded in a thorough understanding of its capabilities and limitations. In this practical guide, we outline several well-described and innovative FGS applications by disease type, including their methods of administration, modes of detection, and typical ICG dosing paradigms. (C) 2020 Elsevier Inc. All rights reserved.

Automated summary

Fluorescence-guided surgery (FGS) is a method of visually enhancing surgical procedures through the injection of fluorescent indocyanine green and detection using a near-infrared camera. It is useful for identifying tumor margins, locating metastases, and other surgical tasks. Surgeons must have a good understanding of ICG pharmacokinetics and NIR detection optics to use FGS judiciously.