Colorectal anastomotic safety assessment using ICG fluorescence and flexible endoscopy (COLOSSEUM): a global survey of 1367 surgeons - Report - MDSpire

Colorectal anastomotic safety assessment using ICG fluorescence and flexible endoscopy (COLOSSEUM): a global survey of 1367 surgeons

  • By

  • A. Belvedere

  • E. Licardie

  • D. Sochorova

  • L. Boni

  • M. Chand

  • S. Perretta

  • S. Wexner

  • T. H. A. Arulampalam

  • A. Morales-Conde

  • S. F. Hardon

  • July 13, 2026

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Global Survey of 1,367 Surgeons on Colorectal Anastomotic Safety Evaluation Utilizing ICG Fluorescence and Flexible Endoscopy (COLOSSEUM)

Overview

This survey assesses the practices of 1,367 surgeons regarding the use of indocyanine green (ICG) fluorescence and flexible endoscopy (FE) in evaluating colorectal anastomotic safety.

Background

Colorectal surgery is a common procedure with a notable risk of anastomotic leaks (AL). Despite advancements in surgical techniques, AL rates remain high.

Data Highlights

No numerical data was provided in the source material.

Key Findings

  • A total of 1,367 surgeons from 83 countries participated in the survey.
  • The mean age of respondents was 64.4 years.
  • Surgeons reported variability in the availability and application of ICG and FE techniques.
  • Survey questions addressed experience levels and opinions on the use of ICG and FE in colorectal surgery.
  • Intraoperative FE may improve detection of anastomotic defects.

Clinical Implications

Surgeons should consider the variability in practice patterns when implementing these techniques.

Conclusion

This survey provides insight into the practices among surgeons regarding ICG and FE use in colorectal surgery.

Related Resources & Content

  1. Innovative Technique for Evaluating Endoluminal Anastomotic Integrity Using Fluoroangiography Following Left-sided Colorectal Resections, Surgical Endoscopy, 2023
  2. Assessment of Bowel Perfusion Using Indocyanine Green Near-Infrared Fluorescence in Colorectal Surgical Procedures, Surgical Endoscopy, 2023
  3. Indocyanine green fluorescence angiography in laparoscopic sigmoid and rectal cancer surgery: no reduction in anastomotic leakage but a lower incidence of anastomotic strictures, Frontiers in Surgery, 2026
  4. 2025 Guidelines for Fluorescence Image-guided Surgery Using Indocyanine Green in Gastrointestinal Procedures - A SAGES Publication
  5. 2025 Systematic Review and Meta-analysis for Fluorescence Image-guided Gastrointestinal Surgery using Indocyanine Green - A SAGES Publication
  6. Surgical Endoscopy — Assessment of Indocyanine Green Fluorescence Angiography in Colorectal Surgical Procedures: A Comprehensive Literature Review
  7. Current guidance on fluorescence image-guided surgery with indocyanine green
  8. 2025 Systematic Review and Meta-analysis for Fluorescence Image-guided Gastrointestinal Surgery using Indocyanine Green - A SAGES Publication
  9. Guidelines for perioperative care in elective colorectal surgery: Enhanced Recovery After Surgery (ERAS) Society recommendations 2025
  10. Indocyanine green near-infrared fluorescence bowel perfusion assessment to prevent anastomotic leakage in minimally invasive colorectal surgery (AVOID): a multicentre, randomised, controlled, phase 3 trial - ScienceDirect
  11. Intraoperative fluorescence angiography with indocyanine green to prevent anastomotic leak in rectal cancer surgery (IntAct): an unblinded randomised controlled trial
  12. Indocyanine Green Fluorescence Imaging in Prevention of Colorectal Anastomotic Leakage: A Randomized Clinical Trial | Trials | JAMA Surgery | JAMA Network
  13. Indocyanine green fluorescence–guided perfusion vs. standard assessment to prevent clinical anastomotic leak after colorectal resection: a GRADE-assessed systematic review and meta-analysis of randomized controlled trials with site-specific subgroup analysis | World Journal of Surgical Oncology | Springer Nature Link
  14. ICG-FA for Anastomotic Leak Prevention During Minimally Invasive Colorectal Surgery: A Meta-analysis - ScienceDirect
  15. Impact of indocyanine green fluorescence angiography on surgeon action and anastomotic leak in colorectal resections. A systematic review and meta-analysis | Surgical Endoscopy | Springer Nature Link
  16. Intraoperative Anastomotic Evaluation Methods: Rigid Proctoscopy Versus Flexible Endoscopy - PubMed

Original Source(s)

Colorectal anastomotic safety assessment using ICG fluorescence and flexible endoscopy (COLOSSEUM): a global survey of 1367 surgeons

  • by A. Belvedere, E. Licardie, D. Sochorova, L. Boni, M. Chand, S. Perretta, S. Wexner, T. H. A. Arulampalam, A. Morales-Conde, S. F. Hardon

  • July 13, 2026

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