Background: Indocyanine green fluorescence vision is an upcoming technology in surgery. It can be used in three ways: angiographic and biliary tree visualization and lymphatic spreading studies. The present paper shows the most outstanding results from an health technology assessment study design, conducted on fluorescence-guided compared with standard vision surgery. Methods: A health technology assessment approach was implemented to investigate the economic, social, ethical, and organizational implications related to the adoption of the innovative fluorescence-guided view, with a focus on minimally invasive approach. With the support of a multidisciplinary team, qualitative and quantitative data were collected, by means of literature evidence, validated questionnaires and self-reported interviews, considering the dimensions resulting from the EUnetHTA Core Model. Results: From a systematic search of literature, we retrieved the following studies: 6 on hepatic, 1 on pancreatic, 4 on biliary, 2 on bariatric, 4 on endocrine, 2 on thoracic, 11 on colorectal, 7 on urology, 11 on gynecology, 2 on gastric surgery. Fluorescence guide has shown advantages on the length of hospitalization particularly in colorectal surgery, with a reduction of the rate of leakages and re-do anastomoses, in spite of a slight increase in operating time, and is confirmed to be a safe, efficacious, and sustainable vision technology. Clinical applications are still presenting a low evidence in the literature. Conclusion: The present paper, under the patronage of Italian Society of Endoscopic Surgery, based on an HTA approach, sustains the use of fluorescence-guided vision in minimally invasive surgery, in the fields of general, gynecologic, urologic, and thoracic surgery, as an efficient and economically sustainable technology.
Could fluorescence-guided surgery be an efficient and sustainable option? A SICE (Italian Society of Endoscopic Surgery) health technology assessment summary / N. Vettoretto, E. Foglia, L. Ferrario, C. Gerardi, B. Molteni, U. Nocco, E. Lettieri, S. Molfino, G.L. Baiocchi, U. Elmore, R. Rosati, G. Curro, E. Cassinotti, L. Boni, R. Cirocchi, A. Marano, W.L. Petz, A. Arezzo, M.A. Bonino, F. Davini, A. Biondi, G. Anania, F. Agresta, G. Silecchia. - In: SURGICAL ENDOSCOPY. - ISSN 0930-2794. - 34:7(2020 Jul), pp. 3270-3284.
|Titolo:||Could fluorescence-guided surgery be an efficient and sustainable option? A SICE (Italian Society of Endoscopic Surgery) health technology assessment summary|
|Parole Chiave:||Fluorescence; Indocyanine green; Laparoscopy; Surgery|
|Settore Scientifico Disciplinare:||Settore MED/18 - Chirurgia Generale|
|Data di pubblicazione:||lug-2020|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1007/s00464-020-07542-3|
|Appare nelle tipologie:||01 - Articolo su periodico|
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