Letter to the Editor “Application and Evaluation of Indocyanine Green Fluorescence Imaging in Pediatric Testicular Torsion Surgery”

We read with great interest the recent article “Application and Evaluation of Indocyanine Green Fluorescence Imaging in Pediatric Testicular Torsion Surgery” by Dai et al., [1]. The study highlights the importance to introduce ICG-NIRF imaging into the challenging setting of pediatric testicular torsion, where intraoperative decision-making remains highly subjective. However, we would like to raise a few important points for consideration. Experimental data have shown that irreversible germ cell necrosis can occur as early as 6 to 8 hours after ischemia, even when reperfusion signals remain detectable.