Fluorescence angiography after vascular ligation to make the ileo-anal pouch reach

J. J. Joosten, M. A. Reijntjes, M. D. Slooter, M. Duijvestein, C. J. Buskens, W. A. Bemelman, R. Hompes

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7 Citations (Scopus)

Abstract

The two most essential technical aspects of any gastrointestinal anastomosis are adequate perfusion and sufficient reach. For ileal pouch-anal anastomosis (IPAA), a trade-off exists between these two factors, as lengthening manoeuvers to avoid tension may require vascular ligation. In this technical note, we describe two cases in which we used indocyanine green (ICG) fluorescence angiography (FA) to assess perfusion of the pouch after vascular ligation to acquire sufficient reach. In both cases, FA allowed us to distinguish better between an arterial inflow problem and venous congestion than white light assessment. Both pouches remained viable and no anastomotic leakage occurred. Our results indicate that ICG FA is of great value after vascular ligation to obtain reach during IPAA.
Original languageEnglish
Pages (from-to)875-878
Number of pages4
JournalTechniques in coloproctology
Volume25
Issue number7
Early online date2021
DOIs
Publication statusPublished - Jul 2021

Keywords

  • Anastomotic leakage
  • Fluorescence angiography (FA)
  • Ileal pouch-anal anastomosis (IPAA)
  • Indocyanine green (ICG)
  • Vascular ligation

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