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

1

Colorectal surgery is a common specialty, with anastomotic leaks occurring in 2.8 to 30 percent of cases, particularly in rectal anastomoses.
2

Indocyanine green (ICG) fluorescence imaging is the most widely used method for assessing tissue perfusion during colorectal surgery.
3

Intraoperative flexible endoscopy (FE) provides critical information on anastomotic integrity and may reduce postoperative complications.
4

A survey of 1,367 surgeons revealed significant variability in the use and protocols for ICG and FE in assessing bowel perfusion.
5

The majority of surgeons reported low anastomotic leak rates for colectomies, but higher rates were noted for rectal surgeries.

Surgical Endoscopy

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

1