Advances in laparoscopic surgery for colorectal cancer: fluorescence- guided surgery

Laparoscopic surgery for colorectal cancer (CRC) has been thoroughly investigated in a multitude of studies and has proved to have equivalent oncologic outcomes to open surgery, yet with the advantages of minimal tissue trauma, shorter hospital stay and quicker recovery. Recent advances in laparoscopic surgical treatment of CRC have been introduced in attempt to enhance the technique and improve the clinical outcome. One of such advances was the fluorescence-guided surgery (FGS) which has already been examined in other surgical specialties. Fluorescenceguided laparoscopic surgery for CRC appeared to be a promising tool to improve the outcome of laparoscopic colorectal surgery on the technical and oncologic levels. On the technical level, FGS can help prevent major complications such as anastomotic leakage and ureteral injury through real-time assessment of bowel perfusion and clear identification of the ureter along its entire course. On the oncologic aspect, FGS can help detect metastatic tumor deposits in the draining lymph nodes, peritoneum, or the liver. Detection of metastatic disease contributes to more accurate staging and enables fluorescence-guided resection of any metastatic lesions which can help increase the overall and disease-free survival rates. The present article aimed to review the current literature for the clinical utility of FGS in the laparoscopic management of colon and rectal cancer, illustrating how FGS can become the next frontier in laparoscopic colorectal surgery.