Background: Endometriosis, a chronic disease affects a substantial number of women worldwide and frequently necessitates surgery. The limitations of traditional laparoscopy, primarily due to the reliance on white-light imaging, might result in incomplete resection of lesions. NIR-ICG fluorescence imaging emerges as a significant innovation, offering improved visualization of endometriotic lesions and surrounding tissues.
Objective: This review evaluates the application and effectiveness of Near-Infrared Indocyanine Green (NIR-ICG) fluorescence imaging in the surgical management of endometriosis, with an emphasis on its utility in enhancing the visualization of critical anatomical structures.

Methods: This review collates data from a variety of studies that have employed NIR-ICG fluorescence imaging in endometriosis surgeries. It details the chemical properties and mechanisms of NIR-ICG, its application in enhancing lesion detection and resection, and its specific roles in visualizing ureters, facilitating nerve-sparing techniques, and ensuring the integrity of bowel surgery.

Results: NIR-ICG fluorescence imaging significantly enhances the visualization of deep infiltrating endometriotic lesions and other critical pelvic structures, thereby reducing the risk of intraoperative injuries. It facilitates more precise lesion excision, aids in preserving essential anatomical features, and improves assessment of tissue perfusion, which is crucial in surgeries that involve bowel resection.

Conclusion: NIR-ICG fluorescence imaging represents a pivotal advancement in the surgical treatment of endometriosis, contributing to improved surgical precision, reduced complication rates, and potentially lowering recurrence. Future research should aim to standardize the use of NIR-ICG in endometriosis surgery, explore its quantitative analysis capabilities, and evaluate long-term surgical outcomes to fully ascertain its clinical benefits and cost-effectiveness.