OBJECTIVE: Indocyanine Green Fluorescence (ICG-F)- guided surgery is becoming an increasingly helpful tool in pediatric surgical care. This consensus statement investigates the utility of ICG-F in various pediatric surgical applications, primarily focusing on its evidence base, safety, indications, use across different surgical specialties and dosing strategies. The aim is to establish an international consensus for ICG-F use in pediatric surgery.
METHODS: An international panel of 15 pediatric surgeons from 9 countries was assembled. The structured process consisted of a rapid scoping review, iterative discussion sessions, mixed-methods studies with key stakeholders, and voting rounds on individual statements to create draft consensus statements.
RESULTS: 100 articles were identified during the review and summarized by application. Based on this condensed evidence, consensus statements were generated after 3 iterative rounds of anonymous voting. Key areas of agreement were quality of evidence, the safety of ICG, pediatric surgical indications, utilization per surgical specialty, and dosing of ICG.
CONCLUSIONS: This consensus statement aims to guide healthcare professionals in managing ICG-F use in pediatric surgical cases based on the best available evidence, key stakeholder consultation, and expert opinions. Despite ICG-F\'s promising potential, the need for higher-quality evidence, prospective trials, and safety studies is underscored. The consensus also provides a framework for pediatric surgeons to utilize ICG-F effectively.
METHODS: III.

Acute mesenteric ischemia (AMI) is still a time-critical and life-threatening clinical picture. If exploration of the abdominal cavity is necessary during treatment, an intraoperative assessment of which segments of the intestines have a sufficient potential for recovery must be made. These decisions are mostly based on purely clinical parameters, which are subject to high level of uncertainty. This review article provides an overview of how this decision-making process and the determination of resection margins can be improved using technical aids, such as laser Doppler flowmetry (LDF), indocyanine green (ICG) fluorescence angiography or hyperspectral imaging (HSI). Furthermore, this article compiles guideline recommendations on the role of laparoscopy and the value of a planned second-look laparotomy. In addition, an overview of strategies for preventing short bowel syndrome is given and other aspects, such as the timing and technical aspects of placement of a preternatural anus and an anastomosis are highlighted.
UNASSIGNED: Die akute mesenteriale Ischämie (AMI) stellt weiterhin ein zeitkritisches und bedrohliches Krankheitsbild dar. Ist im Rahmen der Therapie eine Exploration des Abdomens erforderlich, muss intraoperativ eingeschätzt werden, welche Darmabschnitte ein ausreichendes Erholungspotenzial aufweisen. Diese Entscheidungen basieren meist auf rein klinischen Parametern, die ein hohes Fehlerpotenzial aufweisen. Dieser Übersichtsartikel fasst zusammen, wie Entscheidungsprozesse und die Festlegung von Resektionsgrenzen durch technische Hilfsmittel wie Laser-Doppler-Flowmetrie (LDF), Indocyaningrün(ICG)-Fluoreszenzangiographie oder hyperspektrale Bildgebung (HSI) verbessert werden können. Darüber hinaus stellt dieser Artikel Leitlinienempfehlungen zur Rolle der Laparoskopie und zum Wert einer geplanten Second-Look-Laparotomie zusammen. Außerdem wird ein Überblick über Strategien zur Verhinderung eines Kurzdarmsyndroms gegeben und weitere Aspekte wie das Timing und technische Aspekte von Anus-praeter- und Anastomosenanlagen beleuchtet.