Affordable Indocyanine Green Imaging: A Handmade Low-Cost Camera for Lymphatic Surgery Application.

Background: Indocyanine green (ICG) has become an essential tool in lymphatic and vascular surgery because of its ability to provide real-time, near-infrared fluorescence imaging of both lymphatic structures and blood vessels. This technology enhances intraoperative decision making by allowing the surgeon to evaluate tissue perfusion, visualize lymphatic and blood channels, and confirm the patency of vascular anastomosis. Owing to these advantages, its use has become increasingly popular in lymphaticovenous anastomosis procedures and flap-based reconstructions. However, commercially available ICG imaging systems are associated with high costs, which limits accessibility to this technology. Objectives: To address this limitation, the authors of this study developed a cost-effective camera system for real-time ICG angiography. Methods: In this paper, the authors describe the technical components and assembly process of their camera system. They also share their initial intraoperative experiences with this device in a series of lymphatic surgeries. Results: Early results demonstrate that the camera provides clear imaging of lymphatic channels and blood vessels at a fraction of the cost of standard commercial systems. Its use is reliable and beneficial for intraoperative visualization. Conclusions: The budget-friendly, handmade ICG camera may deliver reliable intraoperative imaging of lymphatic and vascular structures. This approach may broaden the access to ICG technology in resource-limited environments. Level of Evidence 5 Therapeutic: