ABSTRACT
BACKGROUND: Indocyanine green (ICG) is an injectable fluorochrome that has recently gained popularity as a means of assisting intraoperative visualization during laparoscopic and robotic surgery. Many systematic reviews and meta-analyses have been published. We conducted a meta-review to synthesize the findings of these studies. METHODS: PubMed and Embase were searched to identify systematic reviews and meta-analyses coping with the uses of ICG in abdominal operations, including Metabolic Bariatric Surgery, Cholecystectomy, Colorectal, Esophageal, Gastric, Hepato-Pancreato-Biliary, Obstetrics and Gynecology (OG), Pediatric Surgery, Surgical Oncology, Urology, (abdominal) Vascular Surgery, Adrenal and Splenic Surgery, and Interdisciplinary tasks, until September 2023. We submitted the retrieved meta-analyses to qualitative analysis based on the AMSTAR 2 instrument. RESULTS: We identified 116 studies, 41 systematic reviews (SRs) and 75 meta-analyses (MAs), spanning 2013-2023. The most thoroughly investigated (sub)specialties were Colorectal (6 SRs, 25 MAs), OG (9 SRs, 15 MAs), and HPB (4 SRs, 12 MAs). Interestingly, there was high heterogeneity regarding the administered ICG doses, routes, and timing. The use of ICG offered a clear benefit regarding anastomotic leak prevention, particularly after colorectal and esophageal surgery. There was no clear benefit regarding sentinel node detection after OG. According to the AMSTAR 2 tool, most meta-analyses ranked as "critically low" (34.7%) or "low" (58.7%) quality. There were only five meta-analyses (6.7%) that qualified as "moderate" quality, whereas there were no "high" quality reviews. CONCLUSIONS: Regardless of the abundance of pertinent literature and reviews, surgeons should be cautious when interpreting their results on ICG use in abdominal surgery. Future reviews should focus on ensuring methodological vigor; establishing clear protocols of ICG dose, route of administration, and timing; and improving reporting quality. Other sources of data (e.g., registries) and novel methods of data analysis (e.g., machine learning) might also contribute to an enhanced role of ICG as a decision-making tool in surgery.
Subject(s)
Colorectal Neoplasms , Sentinel Lymph Node , Child , Female , Humans , Indocyanine Green , Sentinel Lymph Node Biopsy/methods , Urologic Surgical ProceduresABSTRACT
OBJECTIVES: Isolated ovarian agenesis in the absence of Mullerian duct anomalies are rare events which are usually discovered after menarche and incidentally in the context of an intervention for other indications, such as laparoscopy or assisted reproduction techniques. CASE PRESENTATION: We hereby present a case of unilateral ovarian agenesis in the presence of the ipsilateral fallopian tube. CONCLUSIONS: Older studies had reported an incidence of true congenital unilateral ovarian agenesis to be 1 in 11,241 females Sivanesaratnam V. Unexplained unilateral absence of ovary and fallopian tube. Eur J Obstet Gynecol Reprod Biol 1986;22:103-5, but this is likely an understatement given the increase of relevant literature in recent years and the frequency of laparoscopy nowadays.
Subject(s)
Laparoscopy , Ovary , Female , Humans , Fallopian Tubes/abnormalitiesABSTRACT
This is the first reported case of the use of Monsel's solution to arrest excessive uterine bleeding after the evacuation of retained products of conception after a miscarriage. Monsel's solution impregnated into a uterine pack was used to secure hemostasis. Fertility was preserved because 7 months later the woman became pregnant and had an uncomplicated pregnancy and delivery at term. Monsel's solution can be used therefore if other conventional methods were applied unsuccessfully to stop the uterine hemorrhage.
Subject(s)
Abortion, Spontaneous/surgery , Dilatation and Curettage/adverse effects , Ferric Compounds/administration & dosage , Hemostatics/administration & dosage , Postpartum Hemorrhage/drug therapy , Sulfates/administration & dosage , Administration, Topical , Adult , Blood Transfusion , Female , Gynecologic Surgical Procedures , Humans , Postpartum Hemorrhage/etiology , Postpartum Hemorrhage/therapy , PregnancyABSTRACT
Angiomyofibroblastoma (AMF) is a recently described, rare, benign soft tissue vulvovaginal tumour that occurs mainly but not exclusively in the vulval region of pre-menopausal women (Fletcher et al. in Am J Surg Pathl 16:373; 1992). The first case was diagnosed in 1992. We report a case of a post-menopausal woman with a 2-month history of a rapidly growing painless vaginal tumour and thus drawing the attention of gynaecologist as well as general practitioners to the fact that this rare phenomenon can occur outside the vulva.
