Evaluation of Ovarian Perfusion With Indocyanine Green Dye (ICG) in Patients With Suspected Adnexal Torsion [OP02-4B]

INTRODUCTION: The aim of this study is to assess the safety and feasibility of Indocyanine Green (ICG) dye in patients with adnexal torsion. Our hypothesis is that the use of ICG dye will aid in the surgical determination of tissue viability, ultimately preventing the resection of salvageable ovaries. METHODS: An IRB approved pilot study is currently enrolling patients 18-45 years old with suspected adnexal torsion in a multicentered tertiary care hospital setting. During laparoscopy, the involved adnexa is untwisted and ICG dye is injected intravenously. The untwisted ovary is then observed. Adnexal tissue demonstrating perfusion is preserved and patients are followed postoperatively with anti-Mullerian hormone level and ultrasound. Non-perfused tissue is resected and histologically evaluated for necrosis. RESULTS: Eleven patients with suspected adnexal torsion were enrolled, of which eight had surgically confirmed torsion. Six women demonstrated perfusion with the use of ICG dye even though three of these patients had minimal or no flow on preoperative ultrasound. The remaining 2/8 patients with confirmed torsion failed to demonstrate perfusion with the ICG dye and oophorectomies were performed. One of these patients had confirmed histologic necrosis. There have been no adverse events. CONCLUSION: The use of intravenous ICG dye appears to be a safe and valuable adjunct in the surgical management of adnexal torsion. This may be particularly helpful in patients with diminished adnexal perfusion on preoperative ultrasound. Further research is recommended to determine the generalized role of ICG dye in patients with adnexal torsion.