Colorectal surgery is a treatment for a variety of conditions affecting the colon (large intestine) such as colorectal cancer, diverticulitis, and inflammatory bowel disease. This surgery involves resection, the removal of a section of the colon, and the creation of an anastomosis, which involves surgically connecting the two remaining ends of the bowel after the affected part has been removed. One of the most serious complications of colorectal surgery is anastomotic leak, when the contents of the bowel leak from the anastomosis into the abdominal space, causing an infection that can spread quickly and become a medical emergency. Assessing tissue perfusion, or blood flow, at the planned site of anastomosis is a key step to try to prevent anastomotic leak. The standard approach to assessing anastomotic perfusion involves visual assessment alone, for example, by assessing the colour of the bowel.

Indocyanine green fluorescence imaging (ICGFI) is a technology that involves the use of a fluorescent dye and an imaging system to visualize blood flow. During surgery, the dye is given intravenously and disperses through the blood vessels. When the planned anastomosis site is looked at under near-infrared light, the dye fluoresces bright green, allowing the surgeon to see whether blood flow is adequate.

This health technology assessment looked at how effective and cost-effective ICGFI is when added to colorectal surgery to assess anastomotic perfusion. It also looked at the budget impact of publicly funding ICGFI to assess anastomotic perfusion in colorectal surgery and considered the experiences of patients undergoing colorectal cancer surgery.