TY - JOUR
T1 - Consensus Conference Statement on the General Use of Near-infrared Fluorescence Imaging and Indocyanine Green Guided Surgery
T2 - Results of a Modified Delphi Study
AU - Dip, Fernando
AU - Boni, Luigi
AU - Bouvet, Michael
AU - Carus, Thomas
AU - Diana, Michele
AU - Falco, Jorge
AU - Gurtner, Geoffrey C.
AU - Ishizawa, Takeaki
AU - Kokudo, Norihiro
AU - Lo Menzo, Emanuele
AU - Low, Philip S.
AU - Masia, Jaume
AU - Muehrcke, Derek
AU - Papay, Francis A.
AU - Pulitano, Carlo
AU - Schneider-Koraith, Sylke
AU - Sherwinter, Danny
AU - Spinoglio, Giuseppe
AU - Stassen, Laurents
AU - Urano, Yasuteru
AU - Vahrmeijer, Alexander
AU - Vibert, Eric
AU - Warram, Jason
AU - Wexner, Steven D.
AU - White, Kevin
AU - Rosenthal, Raul J.
N1 - Funding Information:
Disclosures: R.J.R.: Consultant: Diagnostic Green, Medtronics; Stock-Holder: Medicad Simulation; K.W.: Consultant: Diagnostic Green; F.D.: Consultant: Diagnostic Green, Medtronics; S.D.W.: Royalties and consulting fees Intuitive, Medtronic, Karl Storz; Consulting fees: Stryker L.S.: Previous research grant Storz Gmbh; Member, Diagnostic Green Advisory Board; L.B.: Consultant, Karl Storz; A.V.: No relevant financial disclosures; D.S.: No relevant financial disclosures; E.L.: No relevant financial disclosures;M.B.: Consultant, Stryker; S.S-K.: No relevant financial disclosures; M.D.: No relevant financial disclosures; T.C.: No relevant financial disclosures; G.S.: No relevant financial disclosures; N.K.: Research Grant, Hitachi; Paid Lecturer, Eisai Co; D.M.: No relevant financial disclosures; J.W.: No relevant financial disclosures; T.I.: No relevant financial disclosures; Y.U.: No relevant financial disclosures; E.V.: No relevant financial disclosures; P.L.: Founder and stockholder: On Target Laboratories Inc; G.G.: No relevant financial disclosures; J.F.: No relevant financial disclosures; J.M.: No relevant financial disclosures;F.P.: No relevant financial disclosures; C.P.: No relevant financial disclosures.
Publisher Copyright:
© 2022 Lippincott Williams and Wilkins. All rights reserved.
PY - 2022/4/1
Y1 - 2022/4/1
N2 - Background:In recent decades, the use of near-infrared light and fluorescence-guidance during open and laparoscopic surgery has exponentially expanded across various clinical settings. However, tremendous variability exists in how it is performed.Objective:In this first published survey of international experts on fluorescence-guided surgery, we sought to identify areas of consensus and nonconsensus across 4 areas of practice: fundamentals; patient selection/preparation; technical aspects; and effectiveness and safety.Methods:A Delphi survey was conducted among 19 international experts in fluorescence-guided surgery attending a 1-day consensus meeting in Frankfurt, Germany on September 8th, 2019. Using mobile phones, experts were asked to anonymously vote over 2 rounds of voting, with 70% and 80% set as a priori thresholds for consensus and vote robustness, respectively.Results:Experts from 5 continents reached consensus on 41 of 44 statements, including strong consensus that near-infrared fluorescence-guided surgery is both effective and safe across a broad variety of clinical settings, including the localization of critical anatomical structures like vessels, detection of tumors and sentinel nodes, assessment of tissue perfusion and anastomotic leaks, delineation of segmented organs, and localization of parathyroid glands. Although the minimum and maximum safe effective dose of ICG were felt to be 1 to 2 mg and >10 mg, respectively, there was strong consensus that determining the optimum dose, concentration, route and timing of ICG administration should be an ongoing research focus.Conclusions:Although fluorescence imaging was almost unanimously perceived to be both effective and safe across a broad range of clinical settings, considerable further research remains necessary to optimize its use.
AB - Background:In recent decades, the use of near-infrared light and fluorescence-guidance during open and laparoscopic surgery has exponentially expanded across various clinical settings. However, tremendous variability exists in how it is performed.Objective:In this first published survey of international experts on fluorescence-guided surgery, we sought to identify areas of consensus and nonconsensus across 4 areas of practice: fundamentals; patient selection/preparation; technical aspects; and effectiveness and safety.Methods:A Delphi survey was conducted among 19 international experts in fluorescence-guided surgery attending a 1-day consensus meeting in Frankfurt, Germany on September 8th, 2019. Using mobile phones, experts were asked to anonymously vote over 2 rounds of voting, with 70% and 80% set as a priori thresholds for consensus and vote robustness, respectively.Results:Experts from 5 continents reached consensus on 41 of 44 statements, including strong consensus that near-infrared fluorescence-guided surgery is both effective and safe across a broad variety of clinical settings, including the localization of critical anatomical structures like vessels, detection of tumors and sentinel nodes, assessment of tissue perfusion and anastomotic leaks, delineation of segmented organs, and localization of parathyroid glands. Although the minimum and maximum safe effective dose of ICG were felt to be 1 to 2 mg and >10 mg, respectively, there was strong consensus that determining the optimum dose, concentration, route and timing of ICG administration should be an ongoing research focus.Conclusions:Although fluorescence imaging was almost unanimously perceived to be both effective and safe across a broad range of clinical settings, considerable further research remains necessary to optimize its use.
KW - Delphi survey
KW - consensus
KW - fluorescence-guided surgery
KW - indocyanine green
KW - Sentinel Lymph Node
KW - Delphi Technique
KW - Humans
KW - Indocyanine Green
KW - Optical Imaging/methods
KW - Consensus
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U2 - 10.1097/SLA.0000000000004412
DO - 10.1097/SLA.0000000000004412
M3 - Article
C2 - 33214476
AN - SCOPUS:85126072307
SN - 0003-4932
VL - 275
SP - 685
EP - 691
JO - Annals of surgery
JF - Annals of surgery
IS - 4
ER -