Fluorescence-Guided Colorectal Surgery

Fluorescence-guided surgery is an evolving domain within colorectal surgery that leverages real-time imaging to enhance intraoperative visualization and surgical precision. The ongoing challenge in colorectal procedures involves achieving optimal tumor resection and anastomotic integrity while minimizing complications such as anastomotic leaks and residual disease. Traditional techniques based solely on visual and tactile cues can be limited, leading to the need for more reliable intraoperative guidance. Fluorescence-guided methods, particularly those using indocyanine green (ICG), have provided promising advancements by allowing for the dynamic assessment of tissue perfusion and identification of critical anatomical structures. Nevertheless, variable protocols, limited standardization, and mixed evidence regarding clinical outcomes underscore the need for further rigorous evaluation and consensus in clinical practice.

Recent studies have shown that fluorescence guidance can reduce postoperative complications, help delineate tumor margins, and improve identification of vascular structures, potentially translating to better patient outcomes. Notably, advances in imaging technologies and new fluorophores have expanded the application of fluorescence imaging throughout various stages of colorectal surgery, including preoperative mapping and intraoperative navigation. However, debates persist about the best indication for its use, cost-effectiveness, learning curves, and long-term benefits, as well as the integration of this technology into surgical training and routine care. Despite these advancements, large-scale randomized controlled trials and consensus on best practices remain limited, highlighting a significant gap in the current state of the field.

This Research Topic aims to deepen understanding of the value, limitations, and future directions of fluorescence-guided colorectal surgery. It seeks to bring together the latest clinical studies, technological advances, and translational developments to determine where and how fluorescence guidance offers marked improvements in diagnosis, operative strategy, and patient safety. Addressing current knowledge gaps, the Research Topic also intends to foster discussion on barriers to adoption, optimal clinical protocols, and impacts on both short- and long-term outcomes.

To gather further insights into the indications, techniques, and outcomes of fluorescence-guided colorectal surgery, we welcome articles addressing, but not limited to, the following themes:

o Clinical impact of fluorescence imaging on surgical margins and patient outcomes;
o Advances in fluorescence imaging agents and devices;
o Standardization and protocol; development for intraoperative guidance;
o Safety, cost-effectiveness, and workflow integration;
o Applications for education, surgical training, and competency assessment;
o Challenges in translation to routine clinical practice;
o Comparative studies versus traditional and other emerging intraoperative guidance technologies.

The following article types are welcome, Brief Research Report, Clinical Trial, Correction, Curriculum, Instruction, and Pedagogy, Editorial, FAIR² Data, General Commentary, Hypothesis and Theory, Methods, Mini Review, Opinion, Original Research, Perspective, Review, Study Protocol, Systematic Review, Technology and Code.

Article types and fees

This Research Topic accepts the following article types, unless otherwise specified in the Research Topic description:

• Brief Research Report
• Case Report
• Clinical Trial
• Curriculum, Instruction, and Pedagogy
• Editorial
• FAIR² Data
• FAIR² DATA Direct Submission
• General Commentary
• Hypothesis and Theory
• ... View all formats

Articles that are accepted for publication by our external editors following rigorous peer review incur a publishing fee charged to Authors, institutions, or funders.

Article types

This Research Topic accepts the following article types, unless otherwise specified in the Research Topic description:

• Brief Research Report
• Case Report
• Clinical Trial
• Curriculum, Instruction, and Pedagogy
• Editorial
• FAIR² Data
• FAIR² DATA Direct Submission
• General Commentary
• Hypothesis and Theory
• Methods
• Mini Review
• Opinion
• Original Research
• Perspective
• Review
• Study Protocol
• Systematic Review
• Technology and Code

Keywords: Fluorescence-guided surgery, Colorectal surgery, Indocyanine green (ICG), Intraoperative imaging, Surgical navigation, Anastomotic perfusion, Tumor margin identification, Minimally invasive surgery, Imaging technologies, Surgical outcomes, Patient safety

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.