Use of intraoperative indocyanine green fluorescence in determining testicular viability in testicular torsion patients in rural settings: A case report
Bibliographic record
Abstract
INTRODUCTION AND IMPORTANCE: Testicular torsion (TT) is the result of spermatic cord twisting which can lead to significant ischemia, making it a time-sensitive surgical emergency. General surgeons in rural centers may lack the resources to adequately evaluate the viability of the affected testicle. Indocyanine green fluorescence (IGF) has been increasingly used to assess vascular perfusion in general surgery cases. In this case report, we show the use of IGF in a rural setting to assess testicular viability in TT. CASE PRESENTATION: A 17-year-old male was transferred to our rural regional hospital emergency department for sudden and persistent right scrotal pain. The onset of symptoms was approximately 52 h at presentation. TT was diagnosed with a doppler ultrasound by a radiologist. Urgent detorsion surgery was performed. Intraoperative assessment of viability was unclear after the usual means and IGF helped confirm the absence of testicle vascularization and the need for orchiectomy. CLINICAL DISCUSSION: General surgeons in rural communities are called to manage TT with limited resources and experience. IGF is widely used in general surgery and urology. Animal studies and two case reports show potential benefits of IGF in TT. In our patient, IGF was useful to confirm without a doubt that the right testicle was ischemic and non-viable. CONCLUSION: In a rural setting with limited access to radiology and distant urology coverage, IGF is an excellent resource to determine intraoperative blood flow in TT with uncertain viability.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.010 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".