Use of ICG in laparoscopic surgery in children: a comparative study of a single center
DOI:
https://doi.org/10.15574/PS.2026.1(90).2226Keywords:
indocyanine green, laparoscopy, children, fluorescent navigationAbstract
Fluorescent navigation using indocyanine green (ICG) is a modern technology that allows improving intraoperative visualization and increasing the safety of laparoscopic interventions. In pediatric surgery, the experience of its use remains limited.
Aim - to assess the effectiveness and safety of ICG use in laparoscopic, robotic surgical interventions in children compared with traditional laparoscopy.
Materials and methods. A prospective study was conducted on 43 children who underwent laparoscopic interventions using ICG (2023-2025). The control group consisted of 45 children operated on without the use of ICG (2020-2025). The duration of the operation, blood loss, complications, and length of hospitalization were assessed.
Results. The use of ICG provided better visualization of anatomical structures. In the ICG group, a decrease in blood loss, the frequency of complications, and the length of hospitalization were noted.
Conclusions. ICG visualization enables more precise identification of tumor boundaries and other critical structures, reducing the risk of recurrence and complications, and helping to avoid unnecessary tissue removal and damage to healthy structures. ICG laparoscopy, as a minimally invasive surgical technique, allows for procedures with minimal intervention, thereby shortening the recovery period. The lack of standardization in the use of ICG technology in pediatric minimally invasive surgery calls for further analysis and data collection, including in pediatric robotic surgery. The use of ICG in miniinvasive surgery in children is a promising method that can improve treatment outcomes.
The study was conducted in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the local ethics committee of the aforementioned institution. Informed consent was obtained from the patients for the study.
The authors declare no conflict of interest.
References
Chartkichareon A, Tullavardhana T. (2025). Indocyanine green cholangiography in laparoscopic surgery. J Sci. 15(1): 22566. https://doi.org/10.1038/s41598-025-00991-7; PMid:40594014 PMCid:PMC12215707
Dvorakevych AO, Gurayevskyi AA, Stasyshyn AR, Gurayevskyi A-DA, Shevchuk DV, Kalinchuk OO. (2022). The first experience of using robot-assisted surgery in childhood in Ukraine. Paediatric Surgery (Ukraine). 4(77): 91-95. https://doi.org/10.15574/PS.2022.77.91
Esposito C, Masieri L, Cerulo M et al. (2024). Indocyanine green fluorescence in pediatric robotic surgery. J Robot Surg. 18(1): 209. https://doi.org/10.1007/s11701-024-01968-w; PMid:38727915 PMCid:PMC11087303
Hanaki T, Yagyu T, Uchinaka E et al. (2020). Avoidance of bile duct injury using ICG. Clin Case Rep. 8(8): 1419-1424. https://doi.org/10.1002/ccr3.2840; PMid:32884766 PMCid:PMC7455442
Harada K, Fujikawa T, Uemoto Y. (2025). ICG-guided laparoscopic surgery. Asian J Endocr Surg. 18(1): e70120. https://doi.org/10.1111/ases.70120; PMid:40635336
Kaneko J, Ishizawa T, Masuda K et al. (2012). ICG fluorescence angiography. Surg Laparosc Endosc Percutan Tech. 22(4): 341-344. https://doi.org/10.1097/SLE.0b013e3182570240; PMid:22874684
Kitajima T, Fujimoto Y, Hatano E et al. (2015). Fluorescence cholangiography using ICG. Asian J Endosc Surg. 8(1): 71-74. https://doi.org/10.1111/ases.12137; PMid:25598059
Lee AST, Tong CMC. (2025). ICG in pediatric urology. Curr Urol Rep. 26: 26. https://doi.org/10.1007/s11934-025-01256-6; PMid:39907934 PMCid:PMC11799058
MOZ Ukrainy. (2022). Pro vnesennia zmin do Derzhavnoho formuliara likarskykh zasobiv. Nakaz MOZ Ukrainy vid 08.07.2022 No.1173.
Pimentel T, Queiroz I, Gallo Ruelas M et al. (2025). Fluorescent cholangiography: systematic review. Surgery. 181: 109149. https://doi.org/10.1016/j.surg.2025.109149; PMid:39891966
Rathod KJ, Saxena R, Pathak M et al. (2025). ICG in pediatric hepatobiliary surgery. Eur J Pediatr Surg. 35(4): 277-285. https://doi.org/10.1055/a-2509-4463; PMid:39753146
Stasyshyn AR, Huraievskyi AA, Dvorakevych AO, Shevchuk DV, Kalinchuk OO ta in. (2023). Robotychna khirurhiia v Ukraini: pershyi dosvid ta perspektyvy rozvytku. Shpytalna khirurhiia. (1): 5-10.
Tagaya N, Shimoda M, Kato M et al. (2010). ICG imaging in cholecystectomy. J Hepatobiliary Pancreat Sci. 17(5): 595-600. https://doi.org/10.1007/s00534-009-0195-2; PMid:19806299
Une N, Fujio A, Mitsugashira H et al. (2021). Real-time ICG surgery. J Surg Case Rep. 2021(5): rjab196. https://doi.org/10.1093/jscr/rjab196; PMid:34025978 PMCid:PMC8128400
Vlek SL, van Dam DA, Rubinstein SM et al. (2017). Biliary tract visualization using ICG. Surg Endosc. 31(7): 2731-2742. https://doi.org/10.1007/s00464-016-5318-7; PMid:27844236 PMCid:PMC5487840
Downloads
Published
Issue
Section
License
The policy of the Journal “PAEDIATRIC SURGERY. UKRAINE” is compatible with the vast majority of funders' of open access and self-archiving policies. The journal provides immediate open access route being convinced that everyone – not only scientists - can benefit from research results, and publishes articles exclusively under open access distribution, with a Creative Commons Attribution-Noncommercial 4.0 international license(СС BY-NC).
Authors transfer the copyright to the Journal “PAEDIATRIC SURGERY.UKRAINE” when the manuscript is accepted for publication. Authors declare that this manuscript has not been published nor is under simultaneous consideration for publication elsewhere. After publication, the articles become freely available on-line to the public.
Readers have the right to use, distribute, and reproduce articles in any medium, provided the articles and the journal are properly cited.
The use of published materials for commercial purposes is strongly prohibited.
