Surgical Case Reports | VOL. 8
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Successful salvage of torsion testis by means of intraoperative indocyanine green fluorescence imaging

Publication Date Aug 11, 2022

Abstract

Abstract Background Testicular torsion (TT) is common surgical emergency that requires early diagnosis and immediate intervention within 6 h since its onset to salvage the testis. However, the decision was made only by the surgeon’s experience whether it has to be resected or not. Recently, indocyanine green (ICG) has become an excellent tool to identify biliary and vascular anatomy, and assess perfusion abnormalities in tissues. In this case report, we successfully salvaged the twisted testis, since the testicular blood perfusion was confirmed by means of intraoperative ICG (IICG) fluorescence imaging. Case presentation A 14-year-old healthy male patient presented due to acute left testicular pain. The patient was diagnosed with TT and had immediate surgery. Macroscopically, the testis had stagnant blood flow and appeared to be dark colored. After manual detorsion, the testis remained cyanotic and with macroscopically poor blood flow. ICG angiography was performed under near-infrared light by laparoscopic camera to assess the perfusion of the affected testicle. An excellent ICG signal appeared after 45 s in the testis, and decision was made to be preserved. Therefore, left orchidopexy was performed to complete the operation. The patient had a good postoperative course and was discharged the day after surgery. Six months later, the testis did not show any shrinkage, and both sides of the testis showed the same size without any consequences. ...

Concepts

Indocyanine Green Fluorescence Imaging Indocyanine Green Intraoperative Indocyanine Green Fluorescence Intraoperative Indocyanine Green Stagnant Blood Flow Manual Detorsion Successfully Salvaged Indocyanine Green Fluorescence Common Surgical Emergency Indocyanine Green Angiography

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