Can indocyanine green during laparoscopic sleeve gastrectomy be considered a new intraoperative modality for leak testing?

Background Indocyanine green (ICG) when injected intravenously into the bloodstream allows us to show stomach vascularity in real time. The aim of our study was to observe the preliminary results of the application of indocyanine green fluorescence (IGF) during laparoscopic sleeve gastrectomy (LSG) in our center and how the perfusion of the staple line of the stomach affects the onset of fistula. Materials and methods 82 patients underwent LSG with ICG fluorescence angiography at our center from January 2020 to December 2021. 5 ml of ICG was injected intravenously to identify the blood supply of the stomach, carefully assessing the angle of His. Results In the ICG-tested LSG, we recorded adequate perfusion in all patients but one: the leakage rate was 1.2%. This data is inferior to the non-tested patients' group. Conclusion Intraoperative ICG testing may be helpful in determining which patients are at an increased risk for leakage but there are multiple factors contribute to the pathophysiology and the incidence of gastric fistula not only the perfusion. Trial registration Retrospectively registrated

Automated summary

The aim of this study was to observe the preliminary results of indocyanine green fluorescence (IGF) during laparoscopic sleeve gastrectomy (LSG) and investigate the impact of stomach perfusion on fistula formation. Results showed that adequate perfusion was recorded in all except one patient in the ICG-tested LSG group, with a leakage rate of 1.2%. Multiple factors should be considered in determining the risk of leakage.