RT Journal Article
SR Electronic
T1 Assessing the development status of intraoperative fluorescence imaging for perfusion assessments, using the IDEAL framework
JF BMJ Surgery, Interventions, & Health Technologies
FD BMJ Publishing Group Ltd
SP e000088
DO 10.1136/bmjsit-2021-000088
VO 3
IS 1
A1 Takeaki Ishizawa
A1 Peter McCulloch
A1 Derek Muehrcke
A1 Thomas Carus
A1 Ory Wiesel
A1 Giovanni Dapri
A1 Sylke Schneider-Koriath
A1 Steven D Wexner
A1 Mahmoud Abu-Gazala
A1 Luigi Boni
A1 Elisa Cassinotti
A1 Charles Sabbagh
A1 Ronan Cahill
A1 Frederic Ris
A1 Michele Carvello
A1 Antonino Spinelli
A1 Eric Vibert
A1 Muga Terasawa
A1 Mikiya Takao
A1 Kiyoshi Hasegawa
A1 Rutger M Schols
A1 Tim Pruimboom
A1 Yasuo Murai
A1 Fumihiro Matano
A1 Michael Bouvet
A1 Michele Diana
A1 Norihiro Kokudo
A1 Fernando Dip
A1 Kevin White
A1 Raul J Rosenthal
YR 2021
UL http://sit.bmj.com/content/3/1/e000088.abstract
AB Objectives Intraoperative fluorescence imaging is currently used in a variety of surgical fields for four main purposes: assessing tissue perfusion; identifying/localizing cancer; mapping lymphatic systems; and visualizing anatomy. To establish evidence-based guidance for research and practice, understanding the state of research on fluorescence imaging in different surgical fields is needed. We evaluated the evidence on fluorescence imaging for perfusion assessments using the Idea, Development,Exploration, Assessment, Long Term Study (IDEAL) framework, which was designed for describing the stages of innovation in surgery and other interventional procedures.Design Narrative literature review with analysis of IDEAL stage of each field of study.Setting All publications on intraoperative fluorescence imaging for perfusion assessments reported in PubMed through 2019 were identified for six surgical procedures: coronary artery bypass grafting (CABG), upper gastrointestinal (GI) surgery, colorectal surgery, solid organ transplantation, reconstructive surgery, and cerebral aneurysm surgery.Main outcome measures The IDEAL stage of research evidence was determined for each specialty field using a previously described approach.Results 196 articles (15 003 cases) were selected for analysis. Current status of research evidence was determined to be IDEAL Stage 2a for upper GI and transplantation surgery, IDEAL 2b for CABG, colorectal and cerebral aneurysm surgery, and IDEAL Stage 3 for reconstructive surgery. Using the technique resulted in a high (up to 50%) rate of revisions among surgical procedures, but its efficacy improving postoperative outcomes has not yet been demonstrated by randomized controlled trials in any discipline. Only one possible adverse reaction to intravenous indocyanine green was reported.Conclusions Using fluorescence imaging intraoperatively to assess perfusion is feasible and appears useful for surgical decision making across a range of disciplines. Identifying the IDEAL stage of current research knowledge aids in planning further studies to establish the potential for patient benefit.All data relevant to the study are included in the article or uploaded as supplementary information.