Utility of indocyanine-green fluorescent imaging during robot-assisted sphincter-saving surgery on rectal cancer patients

Background There have been few studies describing the use of indocyanine green (ICG) fluorescent imaging during robot‐assisted (RA) sphincter‐saving operations (SSOs) and assessing its potential role in reducing anastomotic leak (AL). Methods A consecutive cohort of 436 rectal cancer patients who underwent curative RA SSOs were prospectively enrolled during 2010–2014, including 123 patients with ICG imaging (ICG+ group) and 313 patients without ICG imaging (ICG– group). Results ICG imaging appeared to be helpful in identifying competent perfusion of the bowel adjacent to the anastomosis in 13 patients (10.6%) who might be susceptible to bowel ischaemia, including restrictive mesocolon. AL was remarkably greater in the ICG– group compared with the ICG+ group (5.4% vs 0.8%; p = 0.031). Conclusions ICG imaging during RA SSO provides accurate real‐time knowledge of the perfusion status at or near the anastomosis, specifically reducing AL in patients who may incur bowel ischaemia. Copyright © 2015 John Wiley & Sons, Ltd.