A Novel Navigation for Laparoscopic Anatomic Liver Resection Using Indocyanine Green Fluorescence

Area of Science:

• Hepatobiliary Surgery
• Minimally Invasive Surgery
• Surgical Navigation Technologies

Background:

• Anatomic liver resection via laparoscopy presents significant navigational challenges compared to open procedures.
• Intraoperative fluorescence imaging with indocyanine green (ICG) has emerged as a valuable tool in liver surgery.
• The PINPOINT system represents a novel advancement in ICG-based intraoperative imaging.

Purpose of the Study:

• To evaluate the efficacy of the novel PINPOINT indocyanine green (ICG) fluorescence system for real-time navigation in laparoscopic anatomic liver resection.
• To assess the system's ability to improve surgical precision and safety in complex liver procedures.

Main Methods:

• The PINPOINT system was utilized for real-time navigation during laparoscopic anatomic liver resections.
• Indocyanine green (ICG) was administered intravenously using a negative counterstaining method.
• Parenchymal transection was guided by the interface between ICG-positive and ICG-negative areas.

Main Results:

• The study included 16 patients undergoing various laparoscopic anatomic liver resections.
• The PINPOINT system achieved a 100% identification rate for clear demarcations.
• Intraoperative blood loss averaged 226 mL, operative time was 305 min, and all patients achieved R0 resection with one major postoperative complication.

Conclusions:

• The PINPOINT ICG system provides clearer images than conventional methods, enhancing real-time navigation.
• This facilitates improved precision and safety in laparoscopic anatomic liver resections.
• The system shows significant potential for advancing minimally invasive liver surgery techniques.