Fluorescence in rectal cancer surgery

Fluorescence image-guided surgery (FIGS) is a relatively emerging optical surgical navigation modality. In the present overview, we will outline the potential role of FIGS applied to rectal oncological surgery. FIGS enables accurate real-time evaluation of bowel perfusion. It allows to visualize the draining lymphatics, providing intraoperative mapping and sentinel node identification to tailor the optimal oncological resection. Critical structures, including ureters, can be highlighted by means of fluorescence to prevent inadvertent injuries. Cancer-specific fluorescent molecules allow to precisely evaluate radical tumor removal and to estimate the surgical margins. Fluorescence-enhanced endoscopy might improve the diagnostic yield.