The usefulness of fluorescence in detecting ischemia during bariatric and metabolic surgery

Abstract

Fluorescence is used in various surgical fields to detect tissue ischemia. However, its use in obesity surgery is still limited. This study aims to investigate whether fluorescence can help detect ischemia during metabolic and bariatric surgery and assess its effectiveness in reducing complications. The main objective was to determine the percentage of patients with improper blood flow assessed by fluorescence and the leak rate. The second outcome measured was the morbidity and mortality within 30 days. This single-centre, prospective observational study analysed patients who underwent primary metabolic and bariatric surgery. Data was collected from 66 consecutive patients who qualified for primary one anastomosis gastric bypass and Roux-en-Y gastric bypass procedures. 30-day postoperative morbidity and mortality were assessed. In total, improper blood supply was observed in two cases out of 66 (3%). No leakage incidents were reported. One patient (1.5%) experienced non-ischemic-related complications. No morbidity and mortality were observed 30 days after the surgical procedures. No complications related to ICG administration were observed. This research shows that adding ICG-fluorescence may reduce the number of MBS-related complications, namely leakage secondary to ischemia. However, this field lacks systematic data, and further research with a larger patient group is necessary to establish conclusive evidence.