IC-Flow™ Indications | Plastic Surgery
Evaluation of flap perfusion
Chest reconstruction, Dr. Ulf Dornseifer, Klinikum Bogenhausen, München, Germany.
In plastic and reconstructive surgery, the IC-Flow™ Imaging System is used to visualize the perfusion of the skin and muscle flaps in real-time, and support the clinical decision making. The real-time assessment of dynamic flap perfusion can be used to select the optimal perforator and to design the flap.For example, the perfusion of a SIEA flap could be observed.
If the perfusion is not sufficient, then the surgeon can switch to a DIEP flap. In addition, following the placement of the flap, the patency of the arterial and venous anastomoses can be checked intraoperatively. Furthermore, the perfusion of the flap can be assessed after transplantation in order to eliminate possible complications.
Visualization of the subcutaneous lymph system
In plastic surgery the IC-Flow™ Imaging System can also be used for lymph angiography to visualize the superficial lymphatics in real-time. The actual anatomy and location of the lymph vessels can be observed. The transportation of lymph can be observed and the flow velocity can be measured.
The most common application of lymph angiography is for the diagnosis and treatment of secondary lymphedema. Secondary lymphedema is one of the most common diseases of the lymphatic system. If left untreated, lymphedema will usually worsen, resulting in strong pain and swelling as well as an increase in the size and weight of the affected limb. Therefore, an early and correct diagnosis along with an appropriate treatment plan are important.2
Performance of Lymphatico-Venous Anastomoses (LVA)
LVA procedure, Professor Masia Jaume, Barcelona (2014)
- Mihara M, Hara H, Araki J, Kikuchi K, Narushima M, Yamamoto T, Iida T, Yoshimatsu H, Murai N, Mitsui K, Okitsu T, Koshima I. Indocyanine Green (ICG) Lymphography Is Superior to Lymphoscintigraphy for Diagnostic Imaging of Early Lymphedema of the Upper Limbs. PLoS One 2012; 7(6): e38182.
- Mihara M, Hara H, Hayashi Y, Iida T, Araki J, Yamamoto T, Todokoro T, Narushima M, Murai N, Koshima I Upper‐Limb Lymphedema Treated Aesthetically with Lymphaticovenous Anastomosis using Indocyanine Green Lymphography and Noncontact Vein Visualization. J Reconstr Microsurg 2012; 28(5): 327‐32
- Mukenge SM, Catena M, Negrini D, Ratti F, Moriondo A, Briganti A, Rigatti P, Cipriani F, Ferla G Assessment and Follow‐Up of Patency After Lymphovenous Microsurgery for Treatment of Secondary Lymphedema in External Male Genital Organs. Eur Urol. 2011; 60(5): 1114‐9
- Yamamoto T, Narushima M, Doi K, Oshima A, Ogata F, Mihara M, Koshima I, Mundinger GS Characteristic indocyanine green lymphography findings in lower extremity lymphedema: the generation of a novel lymphedema severity staging system using dermal backflow patterns. Plast Reconstr Surg 2011; 127(5): 1979‐86
- Takumi Yamamoto, Nana Yamamoto, Takao Numahata, Ai Yokoyama, Kensuke Tashiro, Hidehiko Yoshimatsu, Mitsunaga. „Navigation Lymphatic Supermicrosurgery for the Treatment of Cancer-Related Peripheral Lymphedema”. Vasc Endovascular Surg 2013; epub.
- Unno, N., M. Nishiyama, et al. (2008). Quantitative lymph imaging for assessment of lymph function using indocyanine green fluorescence lymphography. Eur J Vasc Endovasc Surg 36(2): 230-6.
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