{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T02:46:17Z","timestamp":1760150777649,"version":"build-2065373602"},"reference-count":25,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2023,12,30]],"date-time":"2023-12-30T00:00:00Z","timestamp":1703894400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Introduction: There are scarce papers about the use of fluorescence-guided surgery (FGS) in the open surgical field. This study aimed to assess the usefulness of FGS in an open setting in the pediatric population and to report our preliminary experience using the Rubina\u00ae Lens system. Methods: All patients undergoing ICG fluorescence-assisted open surgery over the period September 2022\u2013September 2023 were enrolled. Each surgical procedure was performed using the Rubina\u00ae Lens for ICG fluorescence visualization. Results: A total of 25 patients, 14 boys and 11 girls with a median age at surgery of 5.8 years-old (range 0\u201315), were enrolled. Surgical indications were dermoid\/epidermoid cysts of the head (n = 7), lymphangiomas of the head\/neck (n = 2), thyroglossal duct cysts (n = 7), gynecomastia (n = 3), preauricular fistula (n = 2), second branchial cleft fistula (n = 1), fibrolipoma of the shoulder (n = 1) and myofibroma of the gluteal\/perineal region (n = 2). In all procedures, an intralesional injection of 2.5 mg\/mL ICG solution using a 30-gauge needle was administered. No adverse reactions to ICG occurred. Median operative time was 68.6 min (range 35\u2013189). The visualization of ICG-NIRF with the Rubina\u00ae Lens was achieved in all cases. No intraoperative complications were reported. Postoperative complications occurred in 3\/25 patients (12%), with gynecomastia (n = 1), thyroglossal duct cyst (n = 1) and neck lymphangioma (n = 1), who developed a fluid collection in the surgical site, requiring needle aspiration in outpatient care (Clavien\u2013Dindo 2). Complete mass excision was confirmed with pathology reports. Conclusions: Based on this initial experience, FGS using the Rubina\u00ae Lens was very helpful in open surgery, providing enhanced visualization of anatomy and identification of margins, real-time reliability and low complication rate. It was easy to use, time saving, feasible and clinically safe. Previous experience in MIS is necessary to adopt this technology. The accuracy of the injection phase is important to avoid diffusion of the ICG into the perilesional tissue.<\/jats:p>","DOI":"10.3390\/children11010054","type":"journal-article","created":{"date-parts":[[2023,12,31]],"date-time":"2023-12-31T06:37:12Z","timestamp":1704004632000},"page":"54","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Indocyanine Green (ICG) Fluorescence-Assisted Open Surgery Using the Rubina\u00ae Lens System in the Pediatric Population: A Single-Center Prospective Case Series"],"prefix":"10.3390","volume":"11","author":[{"given":"Ciro","family":"Esposito","sequence":"first","affiliation":[{"name":"Pediatric Surgery Unit, Department of Translational Medical Science, Federico II University, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudia","family":"Di Mento","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Unit, Department of Translational Medical Science, Federico II University, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annalisa","family":"Chiodi","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Unit, Department of Translational Medical Science, Federico II University, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4069-7688","authenticated-orcid":false,"given":"Mariapina","family":"Cerulo","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Unit, Department of Translational Medical Science, Federico II University, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vincenzo","family":"Coppola","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Unit, Department of Translational Medical Science, Federico II University, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fulvia","family":"Del Conte","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Unit, Department of Translational Medical Science, Federico II University, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesca","family":"Carraturo","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Unit, Department of Translational Medical Science, Federico II University, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanni","family":"Esposito","sequence":"additional","affiliation":[{"name":"CEINGE Biotechnology Center, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Escolino","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Unit, Department of Translational Medical Science, Federico II University, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,12,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1016\/j.jpedsurg.2020.08.004","article-title":"Fluorescence imaging in pediatric surgery: State-of-the-art and future perspectives","volume":"56","author":"Paraboschi","year":"2021","journal-title":"J. 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