Article Abstract

Regarding the applications of fusion-fluorescence imaging using indocyanine green in laparoscopic hepatectomy

Authors: Thinzar M. Lwin, Robert M. Hoffman, Michael Bouvet


A critical concern in performing hepatectomy for tumor resection is determining the boundaries of resection and identifying any additional lesions. Obtaining negative margins has a direct impact on disease-free survival in patients (1). The main goal is to remove neoplastic tissue while sparing sufficient normal parenchyma and preserving organ function. Deciding the location of margins in resection for liver neoplasms is based on the location of tumor. Cross-sectional imaging modalities localize the lesion and assist in pre-operative planning, but once in the operating room, the surgeon must rely on visual inspection and tactile feedback along with anatomic knowledge to localize and resect the tumor. In the setting of laparoscopic surgery, this becomes limited as bimanual palpation is no longer possible and tactile feedback becomes limited. This becomes even more so in the setting of robotic surgery as tactile feedback is absent and the surgeon must rely only on visual cues.