Fluorescence image-guided surgery with indocyanine green (ICG) enhances precision for gastrointestinal procedures.

• Strong recommendations for using ICG in detecting non-regional metastases and identifying primary cancers.
• Supported use for lymph node identification in GI cancers and assessing anastomosis quality in esophageal and left-sided colorectal surgeries.

Consider integrating ICG into practice where evidence supports its use to improve surgical outcomes and decision-making.

• Lack of evidence for thoracic duct and certain bariatric applications highlights need for further research.