Fluorescence-guided surgery (FGS) in paediatric surgical centres across the United Kingdom and Ireland: a collaborative research group survey

Abstract

Background: fluorescence-guided surgery (FGS) with Indocyanine Green (ICG) dye enhances intra-operative visualisation of anatomical structures, tissue perfusion, and lymphatic drainage. To inform future practice and collaborative research, we aim to determine current FGS use in paediatric surgical centres in the UK and Ireland (UK&I).

Methods: in November 2023, an online survey of 11 to 21 questions was disseminated to one consultant surgeon at each of the 27 UK&I paediatric surgical centres.

Results: twenty-four of 27 centres (88.9%) responded. Fourteen centres (58.3%) never used FGS, with 7 lacking the appropriate camera. The 10 centres (41.7%) with experience reported recent, limited use, with half performing their first case less than 1 year ago; half used fluorescence on fewer than 5 occasions. The top three indications were oncological procedures, lymphatic assessment, and biliary tree visualisation. A range of ICG doses were reported. Half of the centres had no ICG protocol. Only one centre used FGS in premature neonates. 19/24 (79.2%) deemed FGS helpful or acknowledged future potential; 13/24 (54.2%) believe an FGS registry would be valuable.

Conclusions: current use of FGS in children is limited and non-standardised. An FGS collaborative interest group or UK&I registry could support experience-sharing and standardisation.

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ORCID for Nigel Hall: orcid.org/0000-0001-8570-9374

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