Transformative Role of Next-Gen Infrared Fluorescence Imaging in Esophageal Surgery

A team at the University of Hong Kong applied NIR-II fluorescence imaging during esophagectomy to generate real‑time, objective perfusion maps that can change intraoperative decision‑making. The first clinical use produced video‑based perfusion maps to guide resection and anastomotic site selection, immediately enabling objective, intraoperative perfusion‑guided choices.

Compared with traditional NIR‑I imaging, next‑generation NIR‑II systems deliver superior contrast, higher resolution, and lower background signal. Those physical advantages translate into deeper assessment and clearer margins, yielding more reliable perfusion maps for surgical planning and intraoperative guidance.

By coupling high‑clarity video capture with rapid computational analysis, the approach identified poorly perfused regions on the table and allowed targeted resection. These intraoperative strategy changes were associated with a reduction in anastomotic leaks in the initial series. The method provided objective delineation of perfusion boundaries and reduced reliance on subjective interpretation; observed postoperative complication rates were lower in the early cohort.