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Fluorescence-guided surgery (FGS) represents a transformative advancement in surgical precision, enabling surgeons to visualize critical anatomical structures and assess tissue viability in real-time. At the 8th World Congress of Laparoscopic Surgeons (WALS) 2025, held at The Leela Ambience Gurugram, Dr. Steven D. Wexner, a globally renowned colorectal surgeon and Director of the Digestive Disease Center at Cleveland Clinic Florida, shared pivotal insights from the International Society for Fluorescence Guided Surgery (ISFGS) consensus statement. His presentation underscored the growing role of FGS, particularly with indocyanine green (ICG), in enhancing patient safety and surgical outcomes across various specialties. The Power of Fluorescence-Guided Surgery FGS leverages near-infrared fluorescence imaging to provide surgeons with enhanced visualization during complex procedures. By administering fluorescent agents like ICG, surgeons can assess tissue perfusion, identify sentinel lymph nodes, detect tumors, and delineate critical structures such as ureters or blood vessels. Dr. Wexner emphasized that FGS has moved beyond experimental stages, becoming a cornerstone of modern surgical practice due to its ability to reduce complications and improve precision. At WALS 2025, Dr. Wexner highlighted the consensus statement’s findings, which were informed by international experts and a Delphi survey conducted by the ISFGS. The statement confirmed that FGS is both effective and safe across a broad range of clinical applications, including colorectal, hepatobiliary, and general surgery. Notably, the consensus achieved strong agreement on 41 of 44 statements, reflecting robust confidence in FGS’s utility. Key Applications in Colorectal Surgery Dr. Wexner, a pioneer in colorectal surgery, focused on the transformative impact of ICG-guided FGS in his field. He outlined several key applications: Anastomotic Perfusion Assessment: One of the most established uses of ICG in colorectal surgery is evaluating bowel perfusion during anastomosis. Poor perfusion is a leading cause of anastomotic leaks, which can result in significant morbidity. Dr. Wexner noted that ICG fluorescence angiography allows surgeons to confirm adequate blood flow, reducing leak rates. He cited studies showing promising results, though further research is needed to standardize protocols. Ureter and Urethral Identification: During pelvic dissections, identifying ureters is critical to avoid iatrogenic injuries. ICG imaging provides clear visualization, enhancing safety in complex colorectal procedures. Lymphatic Mapping and Sentinel Lymph Node Detection: ICG aids in identifying sentinel lymph nodes in colorectal cancer, potentially improving staging accuracy and guiding surgical decisions. Hepatic and Peritoneal Metastases Assessment: FGS enables the detection of metastatic lesions, offering a tool for precise tumor localization during surgery. Dr. Wexner emphasized that the primary FDA-approved indication for ICG in the United States remains bowel perfusion assessment. However, he advocated for broader adoption, noting that the location of the anastomosis, rather than the tumor, should guide the use of fluorescence imaging. This approach ensures versatility across colorectal surgeries, including those for rectal cancer, colon cancer, and inflammatory bowel disease (IBD). Insights from the WALS 2025 Consensus Statement The ISFGS consensus statement, as presented by Dr. Wexner, addressed four key areas: fundamentals, patient selection/preparation, technical aspects, and effectiveness/safety. Key takeaways include: Effectiveness and Safety: Experts unanimously agreed that FGS is safe and effective for localizing critical structures, detecting tumors, assessing perfusion, and mapping lymphatics. Its ability to reduce complications, such as anastomotic leaks, was highlighted as a major advantage. Looking Ahead Dr. Steven D. Wexner’s insights from the WALS 2025 Consensus Statement underscore the transformative potential of fluorescence-guided surgery. By enhancing visualization, reducing complications, and improving patient outcomes, FGS is poised to redefine surgical standards. However, its full potential will require ongoing research, standardized protocols, and widespread training. https://www.laparoscopyhospital.com/S... Contact us: World Laparoscopy Hospital Cyber City, Gurugram, NCR Delhi, INDIA Phone/WhatsApp: +919811416838, +919999677788 World Laparoscopy Training Institute Bld. No: 27, DHCC, Dubai, UAE Phone: +971525857874 World Laparoscopy Training Institute 8320 Inv Dr, Tallahassee, Florida, USA Phone: +1 321 250 765