Fluorescence-guided surgery in Latin America: A multinational survey of adoption, barriers, and collaboration.

Abstract

Fluorescence-guided surgery has expanded across multiple surgical specialties, but current patterns of adoption and implementation in Latin America remain incompletely described. This study assessed current use, perceived value, barriers, and readiness for regional collaboration. We conducted a multinational observational survey distributed to 100 surgeons in Latin America. The invited cohort represented a purposive convenience sample identified through regional professional networks. Survey domains included institutional availability, clinical indications, platform use, workflow access, perceived safety and benefit, barriers to implementation, reimbursement, and interest in collaborative data initiatives. Among surveyed respondents, fluorescence-guided surgery is established in parts of Latin America but not yet standardized. Use was most often selective rather than routine, indicating that access is present in many institutions but remains indication dependent. Adoption was concentrated in high-resource settings, particularly tertiary and specialized centers in major metropolitan areas. Clinical use spanned biliary, breast, urologic, and gastrointestinal perfusion applications, with indocyanine green as the dominant fluorophore. Operational access remained constrained, with many respondents reporting shared or inconsistent operating room availability. Barriers were primarily economic and logistical, including limited operating room access, equipment cost, indocyanine green cost, and absent or uncertain reimbursement. Surgeons nevertheless reported favorable safety perceptions, perceived clinical benefit, and strong willingness to participate in regional registries and data sharing. Among surveyed surgeons and participating practice settings, fluorescence-guided surgery implementation was heterogeneous and most often selective rather than routine. The findings should not be interpreted as regional prevalence estimates. Broader implementation may depend on operational access, financing, training, and coordinated data collection in more representative regional cohorts.