Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Clin Cases. May 16, 2026; 14(14): 118964
Published online May 16, 2026. doi: 10.12998/wjcc.v14.i14.118964
Published online May 16, 2026. doi: 10.12998/wjcc.v14.i14.118964
Near-infrared fluorescence with indocyanine green for minimally invasive hernia surgery: A systematic review and evidence synthesis
Lazaros Pavlidis, First Surgical Department, General Hospital of Nikaia-Piraeus, Athens 18454, Greece
Georgios Geropoulos, Vanash Patel, Department of Surgery and Cancer, Imperial College London, St Mary’s Hospital, London WD18 0HB, United Kingdom
Georgios Geropoulos, Kyriakos Psarras, Konstantinos Sapalidis, Styliani Laskou, Third Department of Surgery, University General Hospital of Thessaloniki AHEPA, Aristotle University of Thessaloniki, Thessaloniki 54636, Greece
Konstantinos S Kechagias, Department of Obstetrics and Gynaecology, Imperial College Healthcare NHS trust, London W2 1NY, United Kingdom
Lillian Reza, Nayana Prakash, Department of Surgery and Cancer, Watford General Hospital, Watford WD18 0HB, Hertfordshire, United Kingdom
Christos Athanasiou, Department of General Surgery, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB34NT, Cambridgeshire, United Kingdom
Vasileios Geropoulos, Department of Surgery, School of Medicine, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki 54636, Kentrikí Makedonía, Greece
Elissavet Anestiadou, Fourth Academic Department of Surgery, School of Medical, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece
Tania Triantafyllou, Department of General Surgery, Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, United Kingdom
Dimitrios Dimitroulis, Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens 11527, Greece
Co-first authors: Lazaros Pavlidis and Georgios Geropoulos.
Author contributions: Geropoulos G and Pavlidis L contributed equally to this manuscript and are co-first authors. Geropoulos G, Patel V and Pavlidis L contributed to conception and design of study; Laskou S, Kechagias KS, Triantafyllou T, Anestiadou E, Geropoulos V, Athanasiou C, Athanasiou N, Pavlidis L and Patel V contributed to acquisition of data, analysis and interpretation of data; Geropoulos G, Reza L, Prakash N, Anestiadou E, Geropoulos V and Patel V contributed to drafting of article and final approval; Geropoulos G, Patel V, Psarras K, Sapalidis K and Dimitroulis D contributed to interpretation of data, drafting and revising the article, final approval.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Corresponding author: Vanash Patel, PhD, Associate Professor, Department of Surgery and Cancer, Imperial College London, St Mary’s Hospital, Praed St, London WD18 0HB, United Kingdom. vanash.patel06@imperial.ac.uk
Received: January 16, 2026
Revised: February 5, 2026
Accepted: March 25, 2026
Published online: May 16, 2026
Processing time: 102 Days and 6.4 Hours
Revised: February 5, 2026
Accepted: March 25, 2026
Published online: May 16, 2026
Processing time: 102 Days and 6.4 Hours
Core Tip
Core Tip: Indocyanine green fluorescence imaging is an emerging adjunct in minimally invasive hernia repair. This systematic review synthesises 17 clinical studies and shows that intraoperative indocyanine green is feasible and has not been associated with adverse reactions, while providing real-time assessment of bowel/abdominal wall perfusion in incarcerated or strangulated hernias, improving identification of key inguinal vascular and cord structures, and enabling lymphatic mapping that may help reduce hydrocele. Evidence remains low quality and heterogeneous; standardised protocols and prospective comparative trials are needed before routine adoption.