Diagnostic Value of ICG in Endometriosis

Visualization of Peritoneal Endometriosis With 2D-Laparoscopy and Indocyanine Green

This study evaluates the diagnostic value of the addition of indocyanine green and near infrared fluorescence imaging during laparoscopy in patients with suspected endometriosis.

Endometriosis is a public health problem with an increasing incidence and various symptoms. Surgical treatment reliefs pain and improves fertility by radically removing endometriotic lesions. However, peritoneal endometriotic lesions may vary significantly in their appearance in standard white light laparoscopy and therefore may be difficult to be identified. Because endometriosis is associated with hypervascularisation the visualization of tissue perfusion by additional use of near infrared (NIR) fluorescence imaging with indocyanine green (ICG) may improve the detection of peritoneal endometriotic lesions.

Inclusion Criteria:

• Informed Consent as documented by signature
• Be premenopausal (menopause is defined as amenorrhea lasting one year or longer)
• Patients should be in follicular phase
• Have chronic pelvic pain and/or Infertility and be willing to undergo planned endometriosis resection procedure.

Exclusion Criteria:

• Known or suspected allergy to iodine, shellfish, or ICG dye
• Hyperthyroidism
• Severe renal insufficiency
• Simultaneous therapy with beta-blockers
• Women who are pregnant (positive HCG in the blood) or breast feeding
• Intention to become pregnant during the course of the study
• Inability to follow the procedures of the study (due to language problems, psychological disorders, dementia)
• Active pelvic infection (positive vaginal or cervical smears for bacteria or elevated markers of infection in the blood)
• Previous history of radiation therapy of the pelvis
• Presence of medical conditions contraindicating general anesthesia or standard laparoscopic surgery