fessor in the depart-
ments of surgery and
oncology at Western
University's Schulich
School of Medicine
and Dentistry, and medical director of CSTAR (Canadian Surgical
Technologies & Advanced Robotics) at London (Ontario) Health
Sciences Centre. "What it's really lacking is clinical evidence," he says.
"As often happens in the early stages of a new technology, there's a
learning curve."
Indeed, experts are still trying to determine if there's a clear clinical
indication for the technology, much like what's occurring with robotic
assistance used during orthopedic and abdominal procedures. "Many
key opinion leaders are advocating for the use of ICG in every case,"
says Dr. Schlachta. "But we don't really have that high level of evi-
dence that says it makes a difference. Surgeons are going to be less
inclined to randomize patients to a non-fluorescence imaging arm of a
trial once they decide they really like fluorescence imaging."
Is it worth the investment?
There's really no reason not to add near-infrared fluorescence to your
surgeons' arsenal, especially if you're upgrading OR video systems,
says Dr. Schlachta. The components of a near-infrared fluorescence
system are the light source, a laparoscope with a CCD chip to register
the video image, an image processing unit and video monitors.
The technology is not the extravagance you might think it is, accord-
ing to Dr. Schlachta. He says the cost per case ranges from a couple
hundred dollars to as little as $20, depending on how you acquire your
ICG supply and how you're using it.
Dr. Schlachta's large hospital is upgrading its video system and
7 0 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • N O V E M B E R 2 0 1 9
It's a winning technology.
I can tell you in my own hands,
it changes the way I do surgery.
— Christopher Schlachta, MD