Sylvian dissection with ICG, viewed with FL800 fluorescence

In vascular and neoplastic surgery sylvian dissection is an essential skill. The neurosurgeon needs to recognize the superficial sylvian vein (SSV) in order to safely and accurately achieve a wide opening of the sylvian fissure.  

A report by Dr. Hisashi Kubota and his colleagues at the Department of Neurosurgery, Kindai University Faculty of Medicine, Osaka, Japan, discusses the benefits of indocyanine green (ICG) videoanigiography to demarcate the SSV at the beginning of a sylvian dissection, particularly in patients with subarachnoid hemorrhage. Observation of ICG was enabled by an FL800 vascular fluorescence module from Leica in combination with an M525 OH4 neurosurgical microscope.