Role of Indocyanine Green in Breast Surgery

• Published in: Indian journal of surgery Vol. 84; no. Suppl 3; pp. 592 - 601
• Main Authors: C., Ashok B., Kabilan, Harish Kumar, N., Anantheswar Y., V., Srikanth, P., Somashekar S., Prasad, Archa
• Format: Journal Article
• Language: English
• Published: New Delhi Springer India 01.10.2022; Springer; Springer Nature B.V
• Subjects: Breast surgery; Cardiac Surgery; Fluorescence; Mastectomy; Medicine; Medicine & Public Health; Neurosurgery; Pediatric Surgery; Plastic Surgery; Review Article; Surgery; Surgery, Plastic; Thoracic Surgery; Fluorescence; Indocyanine green; ICG; Breast reconstruction; Breast surgery
• ISSN: 0972-2068; 0973-9793
• DOI: 10.1007/s12262-021-03128-y

The objective of this paper is to give a synopsis of the recent surgical applications of indocyanine green fluorescence imaging methods in breast and breast-related surgeries; the basics of the technology and instrumentation used. Well over 200 papers describing this technique in clinical settings were reviewed. In addition to the surgical applications, other recent medical applications of ICG in breast surgeries are briefly examined. There is currently enough evidence suggesting that reverse lymphatic mapping and SLNB using ICG lymphography provide similar results to those using technetium-99 isotope scanning (Pons et al. Plast Reconstr Surg 147(2):207e–12e, 2021 ). Postoperative mastectomy skin flap necrosis could be thwarted by using intraoperative ICGA to identify mastectomy skin flap areas of inadequate perfusion. It is also one of the most objective and reliable methods to directly assess tissue perfusion in free flap reconstructive surgery, and result in an improvement of (partial) flap survival. Fluorescence imaging is a minimally invasive imaging modality that is useful for the preoperative detection of lymphatic vessels by mapping linear patterns on the patient’s limb and useful in both lymphaticovenular anastomosis and lymphedema screening.