Surgical Endoscopyhttp5/doi.org/10.1007/s00464-023-09928-58CONSENSUS STATEMENTEuropean Association for Endoscopic Surgery (EAES)consensuson Indocyanine Green(ICG)fluorescence-guided surgeryE.Cassinotti1.M.Al-Taher2.S.A.Antoniou3.A.Arezzo4.L.Baldari.L.Boni.M.A.Bonino5.N.D.Bouvy.R.Brodie7.T.Carus8.M.Chand10.M.Diana11.M.M.M.Eussen5.N.Francis12.A.Guida13.P.Gontero14.C.M.Haney15.M.Jansen16.Y.Mintz7.17.S.Morales-Conde18.B.P.Muller-Stich15.K.Nakajima19.F.Nickel15.M.Oderda14.P.Parise20.R.Rosati21.M.P.Schijven2223,24.G.Silecchia13.A.S.Soares10.S.Urakawa19.N.Vettoretto25Received:30 December 2022/Accepted:28 January 2023e The Author(s)2023AbstractBackground In recent years,the use of Indocyanine Green (ICG)fluorescence-guided surgery during open and laparoscopicprocedures has exponentially expanded across various clinical settings.The European Association of Endoscopic Surgery(EAES)initiated a consensus development conference on this topic with the aim of creating evidence-based statements andrecommendations for the surgical communityMethods An expert panel of surgeons has been selected and invited to participate to this project.Systematic reviews of thePubMed,Embase and Cochrane libraries were performed to identify evidence on potential benefits of ICG fluorescence-guided surgery on clinical practice and patient outcomes.Statements and recommendations were prepared and unanimouslyagreed by the panel;they were then submitted to all EAES members through a two-rounds online survey and results presentedat the EAES annual congress,Barcelona,November 2021.Results A total of 18,273 abstracts were screened with 117 articles included.22 statements and 16 recommendations weregenerated and approved.In some areas,such as the use of ICG fluorescence-guided surgery during laparoscopic cholecys-tectomy,the perfusion assessment in colorectal surgery and the search for the sentinel lymph nodes in gynaecologicalmalignancies,the large number of evidences in literature has allowed us to strongly recommend the use of ICG for a betteranatomical definition and a reduction in post-operative complications.Conclusions Overall,from the systematic literature review performed by the experts panel and the survey extended to allEAES members,ICG fluorescence-guided surgery could be considered a safe and effective technology.Future robust clinicalresearch is required to specifically validate multiple organ-specific applications and the potential benefits of this techniqueon clinical outcomes.Keywords Indocyanine green.ICG.Fluorescence-guided surgery.Laparoscopic surgery.Consensus.StatementrecommendationIn the last few years,with the growth and progressive spreadwhich is a modality of intraoperative imaging system thatof minimally invasive surgical techniques,several tools andcould significantly contribute to intraoperative anatomicalinstruments have been developed to enhance surgeons'per-navigation and improve decision-making during the surgicalformance and patient safety and potentially
