Purpose The aim of the present study was to evaluate the usefulness of indocyanine green (ICG) as a preoperative marking dye for laparoscopic colorectal surgery.
Methods Between March 2013 and March 2015, 174 patients underwent preoperative colonoscopic tattooing using 1.0 to 1.5 mL of ICG and saline solution before laparoscopic colorectal surgery. Patients’ medical records and operation videos were retrospectively assessed to evaluate the visibility, duration, and adverse effects of tattooing.
Results The mean age of the patients was 65 years (range, 34–82 years), and 63.2% of the patients were male. The median interval between tattooing and operation was 1.0 day (range, 0–14 days). Tattoos placed within 2 days of surgery were visualized intraoperatively more frequently than those placed at an earlier date (95% vs. 40%, respectively, P < 0.001). For tattoos placed within 2 days before surgery, the visualization rates by tattoo site were 98.6% (134 of 136) from the ascending colon to the sigmoid colon. The visualization rates at the rectosigmoid colon and rectum were 84% (21 of 25) and 81.3% (13 of 16), respectively (P < 0.001). No complications related to preoperative ICG tattooing occurred.
Conclusion Endoscopic ICG tattooing is more useful for the preoperative localization of colonic lesions than it is for rectal lesions and should be performed within 2 days before laparoscopic surgery.
Citations
Citations to this article as recorded by
Enhancing remanent magnetization of injectable hydrogels improves realtime transluminal localization of tumor in hollow soft viscera Junnan Gu, Yuxuan Sun, Tianyi Zhang, Zhenxing Jiang, Falong Zou, Denglong Cheng, Wentai Cai, Hao Wen, Shenghe Deng, Jun Wang, Shuang Zhao, Quanliang Cao, Yinghao Cao, Zichun Yang, Liang Li, Jun Ouyang, Kailin Cai Bioactive Materials.2026; 55: 410. CrossRef
Accuracy evaluation of preoperative indocyanine green tattooing and intraoperative colonoscopy in determining surgical resection margins for left-sided colorectal cancer: a retrospective study in Korea Byung-Soo Park, Sung Hwan Cho, Gyung Mo Son, Hyun Sung Kim, Jin Ook Jang, Dae Gon Ryu, Su Jin Kim, Su Bum Park, Hyung Wook Kim Journal of Minimally Invasive Surgery.2025; 28(1): 19. CrossRef
Beyond diagnosis: how advanced imaging technologies are shaping modern surgery Taner Shakir, Dominic Atraszkiewicz, Mohamed Hassouna, Tom Pampiglione, Manish Chand Artificial Intelligence Surgery.2025; 5(2): 270. CrossRef
Indocyanine Green Tattooing During Colonoscopy as a Guide to Laparoscopic Colorectal Cancer Surgery: A Literature Review Marzia Varanese, Stefano Arcieri, Augusto Lauro, Cristina Panetta, Chiara Eberspacher, Rossella Palma, Domenico Mascagni, Stefano Pontone Surgical Innovation.2024; 31(1): 103. CrossRef
Indocyanine-coated fluorescent clips for localization of gastrointestinal tumors Kyonglin Park, Hongrae Kim, Hyoung-Jun Kim, Yongdoo Choi, Sung-Jae Park, Jae-Suk Park, Min-Kyu Choi, Dae Kyung Sohn Journal of Innovative Medical Technology.2024; 2(1): 20. CrossRef
Preoperative localization of potentially invisible colonic lesions on the laparoscopic operation field: using autologous blood tattooing Ji Yeon Mun, Hyunjoon An, Ri Na Yoo, Hyeon-Min Cho, Bong-Hyeon Kye Annals of Coloproctology.2024; 40(3): 225. CrossRef
A Green Lantern for the Surgeon: A Review on the Use of Indocyanine Green (ICG) in Minimally Invasive Surgery Pietro Fransvea, Michelangelo Miccini, Fabio Rondelli, Giuseppe Brisinda, Alessandro Costa, Giovanni Maria Garbarino, Gianluca Costa Journal of Clinical Medicine.2024; 13(16): 4895. CrossRef
Indocyanine Green Fluorescence Guided Surgery in Colorectal Surgery Zoe Garoufalia, Steven D. Wexner Journal of Clinical Medicine.2023; 12(2): 494. CrossRef
Preoperative tumor marking with indocyanine green (ICG) prior to minimally invasive colorectal cancer: a systematic review of current literature Michael K. Konstantinidis, Argyrios Ioannidis, Panteleimon Vassiliu, Nikolaos Arkadopoulos, Ioannis S. Papanikolaou, Konstantinos Stavridis, Gaetano Gallo, Dimitrios Karagiannis, Manish Chand, Steven D. Wexner, Konstantinos Konstantinidis Frontiers in Surgery.2023;[Epub] CrossRef
Assessment of Autologous Blood marker localIzation and intraoperative coLonoscopy localIzation in laparoscopic colorecTal cancer surgery (ABILITY): a randomized controlled trial Ke-hui Zhang, Jing-ze Li, Hai-bin Zhang, Ren-hao Hu, Xi-mao Cui, Tao Du, Liang Zheng, Shun Zhang, Chun Song, Mei-dong Xu, Xiao-hua Jiang BMC Cancer.2023;[Epub] CrossRef
Indocyanine Green tattooing for marking the caudal excision margin of a full-thickness vaginal endometriotic nodule S Khazali, B Mondelli, K Fleischer, M Adamczyk Facts, Views and Vision in ObGyn.2023; 15(1): 89. CrossRef
Indocyanine green dye and its application in gastrointestinal surgery: The future is bright green Zavier Yongxuan Lim, Swetha Mohan, Sunder Balasubramaniam, Saleem Ahmed, Caroline Ching Hsia Siew, Vishal G Shelat World Journal of Gastrointestinal Surgery.2023; 15(9): 1841. CrossRef
Tumor Segmentation in Colorectal Ultrasound Images Using an Ensemble Transfer Learning Model: Towards Intra-Operative Margin Assessment Freija Geldof, Constantijn W. A. Pruijssers, Lynn-Jade S. Jong, Dinusha Veluponnar, Theo J. M. Ruers, Behdad Dashtbozorg Diagnostics.2023; 13(23): 3595. CrossRef
Fluorescence Imaging in Colorectal Surgery: An Updated Review and Future Trends Paulina Daniluk, Natalia Mazur, Maciej Swierblewski, Manish Chand, Michele Diana, Karol Polom Surgical Innovation.2022; 29(4): 479. CrossRef
Promising Novel Technique for Tumor Localization in Laparoscopic Colorectal Surgery Using Indocyanine Green-Coated Endoscopic Clips Dong Woon Lee, Dae Kyung Sohn, Kyung Su Han, Chang Won Hong, Hyoung Chul Park, Jae Hwan Oh Diseases of the Colon & Rectum.2021; 64(1): e9. CrossRef
Digital dynamic discrimination of primary colorectal cancer using systemic indocyanine green with near-infrared endoscopy Jeffrey Dalli, Eamon Loughman, Niall Hardy, Anwesha Sarkar, Mohammad Faraz Khan, Haseeb A. Khokhar, Paul Huxel, Donal F. O’Shea, Ronan A. Cahill Scientific Reports.2021;[Epub] CrossRef
Endoscopic Preoperative Tattooing and Marking in the Gastrointestinal Tract: A Systematic Review of Alternative Methods Manuel Barberio, Margherita Pizzicannella, Giovanni Guglielmo Laracca, Mahdi Al-Taher, Andrea Spota, Jacques Marescaux, Eric Felli, Michele Diana Journal of Laparoendoscopic & Advanced Surgical Techniques.2020; 30(9): 953. CrossRef
The Usefulness of Preoperative Colonoscopic Tattooing with Autologous Blood for Localization in Laparoscopic Colorectal Surgery Ui Do Yeo, Nak Song Sung, Seung Jae Roh, Won Jun Choi, Kyung Ho Song, In Seok Choi, Dae Sung Yoon, Sang Eok Lee, Ju Ik Moon, Seong Uk Kwon, In Eui Bae, Seung Jae Lee The Journal of Minimally Invasive Surgery.2020; 23(3): 114. CrossRef
Preoperative Colonoscopic Tattooing Using a Direct Injection Method with Indocyanine Green for Localization of Colorectal Tumors: An Efficacy and Safety Comparison Study Young Jin Kim, Ji Won Park, Han-Ki Lim, Yoon-Hye Kwon, Min Jung Kim, Eun Kyung Choe, Sang Hui Moon, Seung-Bum Ryoo, Seung-Yong Jeong, Kyu Joo Park The Journal of Minimally Invasive Surgery.2020; 23(4): 186. CrossRef
Robotic excision of a colonic neoplasm with ICG as a tumor localizer and colonoscopic assistance S. Atallah, A. Oldham, A. Kondek, S. Larach Techniques in Coloproctology.2019; 23(6): 573. CrossRef