Usability of fluorescence angiography with indocyanine green in the surgical management of penetrating abdominal trauma: A case series

Abstract Background The surgical management of penetrating abdominal trauma can be challenging, and despite improvements in diagnostics and treatment, mortality and morbidity rates remain high. Intraoperative fluorescence angiography with indocyanine green (ICG-FA) is currently implemented in many elective surgical settings. However, there are few data regarding the usability of ICG-FA in emergency surgery, and to our knowledge, ICG-FA has not been evaluated in penetrating abdominal trauma. Hence, our objective was to determine the feasibility and usability of ICG-FA in surgical management of penetrating abdominal trauma. Materials and Methods A total of 20 patients undergoing emergency laparotomy for penetrating abdominal trauma were included. The usability of ICG-FA was evaluated using the System Usability Scale (SUS®). The intraoperative macroscopic assessment was compared with that using ICG-FA, and any influence of ICG-FA on surgical management was documented. Results The ICG-FA was completed in all cases and rendered a “good” median SUS® score of 68.8 (interquartile range, 60.6–82.5) by first-time users. The use of ICG-FA influenced surgical management in 14 cases (70%). In six of those cases, ICG-FA significantly changed surgical management. There were no postoperative complications related to surgical management. Conclusion ICG-FA proved usable and relevant in the setting of penetrating abdominal trauma. Although this was only a small case series, the study showed that ICG-FA could substantially influence surgical management of penetrating abdominal trauma, adding considerable patient benefit.