Current Fluorescence-Guided Platforms and Devices

Fluorescence-guided surgery is allowing surgeons to obtain additional real-time information while operating. The use of fluorescence visualization in open and minimally invasive surgeries has created opportunities in a variety of surgical specialties to enhance precision and accuracy of operations. Current fluorescence labeling allows surgeons to better visualize anatomic structures such as blood vessels, lymphatics, and the biliary tree. In this chapter, we describe fluorescence-guided surgical systems currently available for use, divided into the following categories: cart-based and handheld systems for use during open surgery, endoscopic systems for use in minimally invasive surgery, integrated systems which enable both open and minimally invasive use, and robotic systems, as well as a novel laser speckle contrast imaging (LSCI) system that enables a dye-free imaging to detect blood flow and tissue perfusion. We also discuss transillumination devices. This technology has been utilized in a wide range of procedures including intraoperative angiography, tissue identification, and lymphatic tracing with the goal of defining target anatomy in surgical dissections and reconstruction.