Indocyanine Green Fluorescence Navigated Surgery for Esophageal Cancer

Indocyanine green (ICG) fluorescence imaging provides high sensitivity and significant contrast because of its low inherent autofluorescence background and high tissue penetration. Recent studies have shown that ICG fluorescence can visualize the blood flow of the gastric conduit in patients undergoing esophagectomy. We have reported the usefulness of ICG fluorescence imaging as a tool of navigation surgery under esophagectomy. We focused on the ICG fluorescence blood speed on the gastric conduit wall and demonstrated that intraoperative navigation of the blood speed by ICG fluorescence imaging in the gastric conduit wall is a useful means to predict the risk of anastomotic leakage after esophagectomy. Based on the progress of optical electronic equipment, ICG fluorescence imaging can be utilized during endoscopic surgery for gastrointestinal malignancies. Furthermore, robotic surgery is accepted in the Japanese insurance system this year. In near future, ICG fluorescence navigation surgery will improve along with the progress of minimally invasive surgery including the robotic surgery.