Aleksandrov A, Meshulam M, Smith AV, et al. - Generally, deep endometriosis at the level of the rectum represents a solid fibrotic nodule. The development of the disease involves a major role of fibrosis. Indocyanine green is a fluorescent contrast agent, that is used routinely in a wide range of specialties to assess the blood supply and vascularization of different organs and tissues. Researchers here inscribed the benefits of the fluorescence-guided surgery employing indocyanine green (ICG) in the management of deep endometriotic nodules toward more complete and safe excision of the disease in cases when rectal shaving is conducted. In this surgical video, the result of the application of a fluorescent dye (ICG) during deep endometriosis surgery was demonstrated. In a patient undergoing rectal shaving due to a deep endometriotic nodule located at the level of the rectovaginal septum, exploration of the lesion and the anatomical structures was performed in the beginning. The “reverse technique” was used to approach the nodule. Complete resection of the posterior vaginal wall is conducted as the nodule is infiltrating the vagina. ICG is injected at the beginning of the rectal shaving, and its fluorescence effect is utilized to yield navigation for the surgeon during the excision. At the end of the procedure, evaluation of the vascularization of the bowel wall and the vagina was done with the help of the ICG. In this case, ICG use revealed a clear difference between the nodule and the rectum, as well as the vascularization of the bowel wall and the vagina. Observations suggest that during endometriosis surgery, the implementation of ICG could aid navigation for the surgeon toward a more complete and safer management of the disease, decreasing the risk of complications and reinterventions.