Fluorescence angiography is only useful if it is done at the right moment and read consistently. Assess the proximal bowel after mesenteric division and before transection, so a poorly perfused segment can still be trimmed. Give the dye intravenously, flush it, and watch for uniform fluorescence reaching the planned transection line within about a minute.
If the line at the planned transection shows patchy or delayed fluorescence, move proximally to well-perfused bowel. A change of plan is the whole point of the test; recording it builds the unit's own evidence.
- Image the proximal colon after vascular division and before transection
- Look for uniform fluorescence at the transection line, not just somewhere on the segment
- Move the transection proximally if fluorescence is patchy or slow
- Record whether the plan changed and by how much
- Keep the usual checks — pulsatile bleeding, colour, tension — alongside the angiogram
Why it matters
The benefit of fluorescence angiography comes from the change of plan it prompts.
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