・Intriduction
Intraoperative indocyanine green (ICG) fluorography can be helpful for
various digestive surgeries (1) and has a wide range of uses, such as in
the evaluation of blood or bile flow, lesion localization, and boundary
between the lesion and normal tissue (2-5). ICG is generally injected
into the patient’s body via the intravenous or subcutaneous routes.
Determining the exact dissection layer between the internal and external
anal sphincters for laparoscopic intersphincteric resection (ISR) is
often difficult (6). Furthermore, matching the approached dissection
layer from the transanal surgery with that from the transpelvic surgery
is quite challenging. Here, we proposed a procedure that can help
alleviate the difficulty in identifying a suitable dissociated layer by
impregnating gauze with ICG without injecting it into the patient’s body
during laparoscopic ISR.