A novel method for determining adjacent lung segments with infrared thoracoscopy.

Area of Science:

• Surgical Innovation
• Thoracic Surgery
• Medical Imaging

Background:

• Accurate identification of lung intersegmental lines is crucial for precise pulmonary resections.
• Current methods for identifying intersegmental lines can be challenging and may require lung inflation.

Purpose of the Study:

• To evaluate a new technique for identifying lung intersegmental lines using infrared thoracoscopy and indocyanine green.
• To assess the feasibility and accuracy of this method in an animal model.

Main Methods:

• An experimental animal study involving thoracotomy in six beagle dogs.
• Intravenous injection of indocyanine green during infrared thoracoscopy after ligation of the target segment's pulmonary artery.
• Marking the visceral pleura along the color transition zone (blue to white) indicating perfusion status.

Main Results:

• Indocyanine green injection clearly delineated normally perfused lung areas (blue) from non-perfused areas (white).
• The distinct color transition zone allowed for accurate marking of the intersegmental line.
• Computed tomography and pathological analysis confirmed the marking accurately corresponded to the intersegmental line.

Conclusions:

• Infrared thoracoscopy with indocyanine green provides a reliable method for detecting lung intersegmental lines.
• This technique enables visualization without the need for lung inflation, potentially improving surgical planning and execution.