Technique, Outcomes With Navigational Bronchoscopy Using Indocyanine Green for Robotic Segmentectomy

Area of Science:

• Thoracic Surgery
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Robotic segmentectomy is increasingly utilized for lung cancer resection.
• Accurate tumor localization is crucial for successful segmentectomy.
• Indocyanine green (ICG) is a fluorescent dye used for visualization during surgery.

Purpose of the Study:

• To present outcomes of robotic segmentectomy.
• To describe a preferred technique for nodule localization using indocyanine green (ICG) administered both bronchoscopically and intravenously.

Main Methods:

• Retrospective review of 245 consecutive patients undergoing robotic segmentectomy by a single surgeon.
• Indocyanine green administered via electromagnetic navigational bronchoscopy (EMN) and intravenously.
• Detailed description of the preferred ICG localization technique.

Main Results:

• An R0 resection was achieved in all 245 patients.
• Electromagnetic navigational bronchoscopy with ICG identified the target lesion in 86% of cases.
• Intravenous ICG effectively delineated the intersegmental plane for resection.

Conclusions:

• Robotic segmentectomy demonstrates safety and excellent early clinical outcomes.
• EMN with ICG is an efficient and effective method for lesion localization.
• Intravenous ICG is valuable for intersegmental plane delineation in robotic segmentectomy.