scholarly journals Use of indocyanine green to facilitate intersegmental plane identification during robotic anatomic segmentectomy

2014 ◽  
Vol 148 (2) ◽  
pp. 737-738 ◽  
Author(s):  
Alessandro Pardolesi ◽  
Giulia Veronesi ◽  
Piergiorgio Solli ◽  
Lorenzo Spaggiari
Keyword(s):  
Indocyanine Green ◽  
Intersegmental Plane

scholarly journals Hybrid technique of virtual-assisted lung mapping and systemic indocyanine green injection for extended segmentectomy

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Masahiro Yanagiya ◽  
Noriko Hiyama ◽  
Jun Matsumoto
Keyword(s):  
Indocyanine Green ◽  
Hybrid Approach ◽  
Lung Nodule ◽  
Adenocarcinoma In Situ ◽  
Hybrid Technique ◽  
Medical Checkup ◽  
Resection Line ◽  
Intersegmental Plane ◽  
Computed Tomography Image ◽  
Dye Marking

Abstract Background Various approaches have been used to assist and facilitate segmentectomy with favorable oncological outcomes. We describe a hybrid approach comprising virtual-assisted lung mapping (VAL-MAP), which is a preoperative bronchoscopic dye-marking technique, combined with systemic indocyanine green (ICG) injection. Clinical presentation An asymptomatic 64-year-old man was referred to our department because of a lung nodule detected during his annual medical checkup. The chest computed-tomography image revealed a 16-mm, partly solid, ground-glass nodule in the left segment 4. Because the nodule was hardly palpable and deeply located between the left upper division segment and the left lingular segment, we performed VAL-MAP to facilitate extended left lingulectomy. Five dye markings were undertaken preoperatively. Surgery to remove the nodule was then conducted via complete three-port video-assisted thoracic surgery. The VAL-MAP markings were easily identified intraoperatively and helped locate the nodule. The intersegmental plane was identified by the ICG injection. The resection line was determined based on the intersegmental plane identified by the ICG injection and the site of the nodule suggested by the VAL-MAP markings. Following the resection line, we thoracoscopically achieved extended lingulectomy with sufficient surgical margins. The patient was discharged with no complications. The pathological diagnosis was adenocarcinoma in situ. Conclusion The hybrid technique of VAL-MAP and systemic ICG injection can be useful for accomplishing successful extended segmentectomy.

A Pilot Study of Pulmonary Segmentectomy With Indocyanine Green Near-Infrared Angiography

2019 ◽  
Vol 26 (3) ◽  
pp. 337-343 ◽  
Author(s):  
Ruiji Chen ◽  
Yongfu Ma ◽  
Chengrun Li ◽  
Yunjing Li ◽  
Bo Yang ◽  
...  
Keyword(s):  
Pilot Study ◽  
Indocyanine Green ◽  
Chest Tube ◽  
Near Infrared ◽  
Thoracoscopic Surgery ◽  
Operation Time ◽  
Ground Glass Opacity ◽  
Perioperative Period ◽  
Intersegmental Plane ◽  
The Mean

Objectives. Video-assisted thoracoscopic surgery (VATS) pulmonary segmentectomy is commonly used in treating small ground-glass opacity (GGO) nodules in lung. The identification of the intersegmental plane is one of the challenges. In this pilot study, we aimed to evaluate the feasibility of indocyanine green (ICG) angiography in VATS segmentectomy. Methods. Nineteen GGO patients were enrolled, and VATS segmentectomy with ICG near-infrared angiography were performed between July 2017 and December 2017. Conventional 3-port VATS was used. ICG was injected intravenously after dominant arties were ligated. Intersegmental plane was identified and divided by stapler and electrocautery. Results. All patients had perfect intersegmental plane visualization. The mean operation time was 140.8 minutes, and the mean blood loss was 23.7 mL. No complications due to ICG occurred. The mean chest tube duration was 4.6 days. No severe complications occurred in the perioperative period. The mean chest tube drainage duration was 4.6 days. Prolonged postoperative air leak (>5 days), which required no surgical intervention, occurred in 2 cases. There were no severe complications or in-hospital deaths. Conclusions. VATS segmentectomy with ICG near-infrared angiography is a reasonable treatment option to treat small GGO in lung, especially due to its good surgical view maintenance.

scholarly journals Simultaneous visualization of pulmonary nodules and intersegmental planes on fluorescent images in pulmonary segmentectomy

2020 ◽  
Vol 58 (Supplement_1) ◽  
pp. i77-i84
Author(s):  
Yeasul Kim ◽  
Jiyun Rho ◽  
Yu Hua Quan ◽  
Byeong Hyeon Choi ◽  
Kook Nam Han ◽  
...  
Keyword(s):  
Indocyanine Green ◽  
Resection Margin ◽  
Pulmonary Nodules ◽  
Resection Margins ◽  
Adenocarcinoma In Situ ◽  
Segmental Artery ◽  
Mean Size ◽  
Intersegmental Plane ◽  
The Mean

Abstract OBJECTIVES The technique of simultaneously visualizing pulmonary nodules and the intersegmental plane using fluorescent images was developed to measure the distance between them intraoperatively. METHODS Patients who underwent pulmonary segmentectomy were consecutively included in this study between March 2016 and July 2019. Computed tomography or electromagnetic bronchoscopy-guided localization with indocyanine green–lipiodol emulsion was performed on the day of surgery. In the middle of the surgery, after dividing the segmental artery, vein and bronchus to a targeted segment, 0.3–0.5 mg/kg of indocyanine green was injected intravenously. RESULTS In total, 31 patients (17 men and 14 women with a mean age of 63.2 ± 9.8 years) were included in this study. The mean size and depth of the nodules were 1.2 ± 0.5 (range 0.3–2.5) cm and 16.4 ± 9.9 (range 1.0–42.0) mm, respectively. Pulmonary nodules and intersegmental plane of all the patients were visualized using a fluorescent thoracoscope. The resection margins were more than the size of the tumour or were 2 (mean 2.4 ± 1.2) cm in size in all patients except one. The resection margin of this patient looked sufficient on the intraoperative view. However, adenocarcinoma in situ at the resection margin was identified based on the pathological report. The mean duration of the operation was 168.7 ± 53.3 min, and the chest tube was removed on an average of 4.7 ± 1.8 days after surgery in all patients. CONCLUSIONS The dual visualization technique using indocyanine green could facilitate an easier measurement of the distance between pulmonary nodules and the intersegmental plane during pulmonary segmentectomy.

scholarly journals Fluorescence visualization of the intersegmental plane by bronchoscopic instillation of indocyanine green into the targeted segmental bronchus: determination of the optimal settings

2021 ◽  
Vol 49 (2) ◽  
pp. 030006052199020
Author(s):  
Takashi Anayama ◽  
Kentaro Hirohashi ◽  
Ryohei Miyazaki ◽  
Hironobu Okada ◽  
Marino Yamamoto ◽  
...  
Keyword(s):  
Indocyanine Green ◽  
Near Infrared ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Green Fluorescence ◽  
Indocyanine Green Fluorescence ◽  
Segmental Bronchus ◽  
Segment Volume ◽  
Intersegmental Plane

Objective To determine the appropriate amount of indocyanine green for bronchial insufflation. Methods We enrolled 20 consecutive patients scheduled for anatomical segmentectomy in the Kochi Medical School Hospital. After inducing general anesthesia, 6 to 60 mL of 200-fold-diluted indocyanine green (0.0125 mg/mL) was insufflated into the subsegmental bronchi in the targeted pulmonary segmental bronchus. The volume of the targeted pulmonary segments was calculated using preoperative computed tomography. Fluorescence spread in the segmental alveoli was visualized using a dedicated near-infrared thoracoscope. Results The targeted segment was uniformly visualized by indocyanine green fluorescence in 16/20 (80.0%) cases after insufflating indocyanine green. A receiver operating characteristic curve indicated that the area under the curve was 0.984; the optimal cut-off volume of diluted indocyanine green for insufflation was 8.91% of the calculated targeted pulmonary segment volume. Conclusions The setting for indocyanine green insufflation was optimized for near-infrared fluorescence image-guided anatomical segmentectomy. By injecting the correct amount of indocyanine green, fluorescence-guided anatomical segmentation may be performed more appropriately.

Dorsal (S2) segmentectomy of right upper lobe via a uniportal approach using near infrared imaging and indocyanine green administration

2020 ◽  
Keyword(s):  
Indocyanine Green ◽  
Near Infrared ◽  
Infrared Imaging ◽  
Primary Lung Cancer ◽  
Surgical Instruments ◽  
Near Infrared Imaging ◽  
Video Tutorial ◽  
Intersegmental Plane ◽  
The Right ◽  
Green Technique

Uniportal video-assisted thoracic surgery is becoming more common worldwide, but the limited angle of approach of inserted surgical instruments makes it challenging. Because of this, segmentectomy via a uniportal approach is more difficult technically than a multiportal approach. In addition, the inflation/deflation technique, which is a standard method for identifying the intersegmental plane, is often less useful because it can be difficult to get a good surgical view. To resolve this problem, a technique using near infrared imaging and indocyanine green administration technique can be very helpful in performing a uniportal segmentectomy. In this video tutorial, we demonstrate a uniportal thoracoscopic dorsal segmentectomy of the right upper lobe of a patient with primary lung cancer, using a near infrared imaging/indocyanine green technique. We explain the nuances of the procedure and how to perform it, and we discuss our successful results.

scholarly journals Uniportal video-assisted thoracic lung segmentectomy with near infrared/indocyanine green intersegmental plane identification

2018 ◽  
Vol 4 ◽  
pp. 17-17 ◽  
Author(s):  
Elisa Meacci ◽  
Dania Nachira ◽  
Maria Teresa Congedo ◽  
Marco Chiappetta ◽  
Leonardo Petracca Ciavarella ◽  
...  
Keyword(s):  
Indocyanine Green ◽  
Near Infrared ◽  
Video Assisted ◽  
Intersegmental Plane
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