Improved outcomes of fluorescence-guided laparoscopic lymph node biopsy vs. conventional laparoscopic technique in lymphoma diagnosis.

This study compared the clinical outcomes and diagnostic accuracy of Fluorescence-guided laparoscopic lymph node biopsy (FGLLB) with conventional laparoscopic lymph node biopsy (LLB) at a single institution. We compared 42 patients who underwent FGLLB between April 2022 and September 2025 with a historical group of 55 LLB patients. The main outcomes measured were surgical time, blood loss, surgical conversion rates, hospital stay, and morbidity. Diagnostic accuracy was the secondary outcome. Surgical conversion occurred in one FGLLB patient (2.3%) and two LLB patients (3.6%) due to surgical difficulties. Surgical time was shorter in the FGLLB group (67.5 ± 33.7 min) compared to the LLB group (83 ± 22.2 min), though this difference was not statistically significant (p = 0.093). The average hospital stay was also shorter for FGLLB patients (1.6 days) compared to LLB patients (2.2 days), a difference that nearly reached statistical significance (p = 0.073). Minor postoperative complications were observed in two FGLLB patients and one LLB patient (4.7% vs 1.8%, p = 0.411). The biopsy provided the necessary diagnostic information in 97.6% of FGLLB cases and 96.3% of LLB cases. FGLLB showed good procedural and postoperative outcomes and a high diagnostic yield, comparable to traditional LLB. FGLLB was associated with shorter surgical times and hospital stays. The fluorescence guidance makes dissection more precise and safer by targeting a visible structure, which helps avoid unnecessary dissection and may contribute to the reduced surgical duration. More research is needed to confirm the reliability of this technique before it is widely adopted.