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Monti et al: Near‐infrared fluorescence‐guided minimally invasive surgery for iliosacral lymph node removal in 18 dogs (2023–2025)
Veterinary Surgery 6, 2025

🔍 Key Findings

  • Laparoscopic ISLN removal using NIRF-ICG was feasible in 89% of dogs (16/18), demonstrating high procedural success with minimal invasiveness.
  • Median laparoscopic dissection time was only 12 minutes, suggesting efficiency of the NIRF-guided approach.
  • No postoperative complications were observed, and intraoperative complications occurred in only 2 dogs (11.1%), both requiring conversion to open surgery.
  • Metastatic disease was confirmed in 48% of patients (12/25 nodes), including cases where LNs appeared normal in size, highlighting the value of histologic evaluation.
  • NIRF-ICG enabled precise identification of small and mildly enlarged nodes, which are often missed during traditional imaging or palpation.
  • Fluorescent dye leakage following LN capsule rupture limited visibility and required surgical conversion, indicating a key limitation of the technique.
  • ICG signal was occasionally absent in metastatic LNs, likely due to lymphatic rerouting or obstruction, underscoring limitations in SLN identification.
  • The lateral approach allowed consistent access to ipsilateral MILN, IILN, and sacral LNs, though contralateral nodes were inaccessible with this method.

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← Articles

Monti et al: Near‐infrared fluorescence‐guided minimally invasive surgery for iliosacral lymph node removal in 18 dogs (2023–2025)
Veterinary Surgery 6, 2025

🔍 Key Findings

  • Laparoscopic ISLN removal using NIRF-ICG was feasible in 89% of dogs (16/18), demonstrating high procedural success with minimal invasiveness.
  • Median laparoscopic dissection time was only 12 minutes, suggesting efficiency of the NIRF-guided approach.
  • No postoperative complications were observed, and intraoperative complications occurred in only 2 dogs (11.1%), both requiring conversion to open surgery.
  • Metastatic disease was confirmed in 48% of patients (12/25 nodes), including cases where LNs appeared normal in size, highlighting the value of histologic evaluation.
  • NIRF-ICG enabled precise identification of small and mildly enlarged nodes, which are often missed during traditional imaging or palpation.
  • Fluorescent dye leakage following LN capsule rupture limited visibility and required surgical conversion, indicating a key limitation of the technique.
  • ICG signal was occasionally absent in metastatic LNs, likely due to lymphatic rerouting or obstruction, underscoring limitations in SLN identification.
  • The lateral approach allowed consistent access to ipsilateral MILN, IILN, and sacral LNs, though contralateral nodes were inaccessible with this method.

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Multiple Choice Questions on this study

In Monti 2025 et al., on lymph node fluorescence imaging, what was the observed postoperative complication rate following laparoscopic ISLN removal using NIRF-ICG?

A. 0%
B. 5%
C. 10%
D. 15%
E. 20%

Answer: 0%

Explanation: No postoperative complications were recorded during hospitalization or follow-up.
In Monti 2025 et al., on lymph node fluorescence imaging, what was the most common intraoperative complication encountered during NIRF-ICG guided laparoscopic ISLN excision?

A. Mild hemorrhage controlled with compression
B. Instrument failure requiring procedure halt
C. Capsular disruption with dye leakage
D. Laparoscopic port site dehiscence
E. Anesthetic reaction

Answer: Capsular disruption with dye leakage

Explanation: Capsular rupture with ICG dye dispersion was reported in one of the two dogs requiring conversion to open surgery.
In Monti 2025 et al., on lymph node fluorescence imaging, which factor was identified as a limitation of ICG uptake for sentinel lymph node identification?

A. Tumor ulceration obstructing dye flow
B. Prolonged anesthesia interfering with perfusion
C. Neoplastic obstruction of lymphatics
D. Excessive fat causing signal attenuation
E. Incorrect ICG dose

Answer: Neoplastic obstruction of lymphatics

Explanation: Lymphatic rerouting or blockage due to tumor invasion reduced ICG uptake in some nodes, limiting their intraoperative visualization.
In Monti 2025 et al., on lymph node fluorescence imaging, what was the median dissection time during laparoscopic removal of iliosacral lymph nodes using NIRF-ICG?

A. 6 minutes
B. 9 minutes
C. 12 minutes
D. 18 minutes
E. 28 minutes

Answer: 12 minutes

Explanation: The median dissection time reported was 12 minutes, indicating a relatively efficient surgical technique.
In Monti 2025 et al., on lymph node fluorescence imaging, which lymph node group was most frequently identified and removed using NIRF-guided laparoscopic surgery?

A. Internal iliac lymph nodes
B. Sublumbar lymph nodes
C. Medial iliac lymph nodes
D. Superficial inguinal lymph nodes
E. Sacral lymph nodes

Answer: Medial iliac lymph nodes

Explanation: The medial iliac lymph nodes (MILNs) were the most commonly identified and excised fluorescent nodes.

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