Effectiveness of Indocyanine Green Fluorescence Imaging in Evaluating Mesenteric Injury After Transvaginal Oocyte Retrieval: A Case Report

Abstract

A 41-year-old woman presented with a constant abdominal pain that had begun immediately following a transvaginal oocyte retrieval. CT revealed extravasation from the mesenteric vessels and hemorrhagic ascites. The obstetrician and gynecologist on call performed open hemostasis, and we also provided interventional assistance. Intraoperatively, we recognized damage of the sigmoid mesentery and mesenteric vessels. No discoloration of the sigmoid colon was observed, although a few straight arteries supplying the sigmoid colon were damaged. Therefore, we evaluated colonic blood flow perfusion by indocyanine green fluorescence imaging. As no blood perfusion was observed within a 4-cm diameter circular area around the sigmoid colon, we resected the sigmoid colon and performed functional end-to-end anastomosis. The number of complications in the field of reproductive medicine is increasing every year, and we expect that non-obstetricians will be dealing with an increasing number of complications of transvaginal oocyte retrieval. In this case, we evaluated the intestinal blood flow using indocyanine green fluorescence imaging. The imaging is useful to visually confirm the extent of ischemia in cases of mesenteric injury.