Laparoscopic anatomical liver resection using indocyanine green fluorescence imaging

Urade, Takeshi; Sawa, Hirofumi; Iwatani, Yoshinori; Abe, Tomoki; Fujinaka, Ryosuke; Murata, Koichi; Mii, Yasuhiko; Man-i, Mariko; Oka, Shinichi; Kuroda, Daisuke

doi:10.1016/j.asjsur.2019.04.008

Cited by 60 publications

(49 citation statements)

References 13 publications

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“…Laparoscopic hepatectomy is now performed widely to cure benign and malignant liver diseases [1]. To mark the demarcation line, portal staining or inflow clamping of the target area is recommended in conventional open anatomical liver resection [2][3][4]. Conversely, in laparoscopic hepatectomy, this requires advanced skills.…”

Section: Introductionmentioning

confidence: 99%

Indocyanine green fluorescence navigation in laparoscopic hepatectomy: a retrospective single-center study of 120 cases

Liang

Qian

et al. 2020

Surg Today

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Purpose To explore the role of indocyanine green (ICG) fluorescence navigation in laparoscopic hepatectomy and investigate if the timing of its administration influences the intraoperative observation. Methods The subjects of this retrospective study were 120 patients who underwent laparoscopic hepatectomy; divided into an ICG-FN group (n = 57) and a non-ICG-FN group (n = 63). We analyzed the baseline data and operative data. Results There were no remarkable differences in baseline data such as demographic characteristics, lesion-related characteristics, and liver function parameters between the groups. Operative time and intraoperative blood loss were significantly lower in the ICG-FN group. The rate of R0 resection of malignant tumors was comparable in the ICG-FN and non-ICG-FN groups, but the wide surgical margin rate was significantly higher in the ICG-FN group. The administration of ICG 0–3 or 4–7 days preoperatively did not affect the intraoperative fluorescence imaging. Operative time, intraoperative blood loss, and a wide surgical margin correlated with ICG fluorescence navigation. ICG fluorescence navigation helped to minimize intraoperative blood loss and achieve a wide surgical margin. Conclusion ICG fluorescence navigation is safe and efficient in laparoscopic hepatectomy. It helps to achieve a wide surgical margin, which could result in a better prognosis. The administration of ICG 0–3 days preoperatively is acceptable.

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Section: Introductionmentioning

confidence: 99%

Indocyanine green fluorescence navigation in laparoscopic hepatectomy: a retrospective single-center study of 120 cases

Liang

Qian

et al. 2020

Surg Today

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“…Regarding space-occupying lesions in the right liver, intraoperative real-time guidance of the section not only maximized the preservation of normal hepatic lobe tissue 17 but the irregular resection along the most accurate fluorescent border also avoided unnecessary intrahepatic vascular injury. 18 Preoperative 3D imaging allows the reconstructed image to be adjusted freely at 360° in real time during the operation and can be divided into liver segment imaging. According to the liver and tumor model of 3D imaging, the surgical image of real-time coincidence fluorescence imaging can even achieve the naked separation of secondary and even tertiary blood vessels in the fine anatomy of the ultrasonic scalpel.…”

Section: Discussionmentioning

confidence: 99%

Precision Liver Resection: Three-Dimensional Reconstruction Combined with Fluorescence Laparoscopic Imaging

Lin

Wang

et al. 2020

Surg Innov

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Liver surgery has entered the era of precision surgery. Therefore, how to optimize the resection of lesions and reduce the unnecessary time of liver ischemia and hypoxia have become the focus. A total of 11 patients who underwent fluorescence laparoscopic liver mass resection and preoperative three-dimensional (3D) reconstruction between August 2018 and July 2020 were evaluated. Liver cirrhosis occurred in 3 patients. The mean intraoperative blood loss was 166.8 ± 105.7 mL. The average length of the operation time was 152.0 ± 45.3 minutes. The average intraoperative hilar occlusion time was 9.3 minutes (except for hilar cholangiocarcinoma). The liver function of all patients, except patients with hilar bile duct carcinoma, returned to the preoperative level at 72 hours, and no serious complications occurred. 3D reconstruction combined with fluorescence laparoscopic imaging is safe and effective for precision liver resection.

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“…However, there are limitations to using this method. As noted by Urade et al [71], fluorescence tomography with ICG does not allow to identify the landmarks of liver segments having a complex three-dimensional structure, which makes it difficult to conduct anatomical laparoscopy. In addition, ICG fluorescence in the near infra-red range has a limited penetrative ability in biological tissues.…”

Section: Clinical Methods For Assessing Functional and Structural Chamentioning

confidence: 99%

Modern Methods for Assessing the Regenerative Potential of the Liver after Partial Hepatectomy (Review)

Rodimova¹,

Kuznetsova²,

Bobrov³

et al. 2019

Sovrem Tehnol Med

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The review addresses the main methods for assessing the function and regenerative potential of the liver. They include both the traditional methods, commonly used in clinical practice, and the latest promising techniques suitable for the analysis of cellular and tissue pathology and having a proven diagnostic value.It is known that the dynamics of liver regeneration is reflected in the metabolic status of liver cells, their morphology, and the molecular rearrangement. Therefore, by looking at these parameters we will be able to assess the regenerative potential of the liver as a whole.At present, the most promising method is represented by multiphoton microscopy able to generate the second harmonic; there are also such techniques as coherent anti-stokes Raman spectroscopy (CARS), stimulated Raman scattering (SRS) microscopy, and fluorescence lifetime imaging microscopy (FLIM). In addition, a number of options for analyzing metabolic and structural changes are provided by mass spectrometry, in particular time-of-flight secondary ion mass spectrometry (ToF-SIMS). Studies using these methods with in vivo models and with human biopsy samples demonstrate their relevance in biomedical research and in clinical practice alike.

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Laparoscopic anatomical liver resection using indocyanine green fluorescence imaging

Cited by 60 publications

References 13 publications

Indocyanine green fluorescence navigation in laparoscopic hepatectomy: a retrospective single-center study of 120 cases

Indocyanine green fluorescence navigation in laparoscopic hepatectomy: a retrospective single-center study of 120 cases

Precision Liver Resection: Three-Dimensional Reconstruction Combined with Fluorescence Laparoscopic Imaging

Modern Methods for Assessing the Regenerative Potential of the Liver after Partial Hepatectomy (Review)

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