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Updated: Jan 25, 2026
05:27
Laparoscopic Anatomical Hepatectomy Using Takasaki's Approach and Indocyanine Green Fluorescence Navigation
Published on: May 16, 2025
848
Laparoscopic anatomical liver resection using indocyanine green fluorescence imaging
Takeshi Urade1, Hidehiro Sawa1, Yoshiteru Iwatani2
1Department of Surgery and Digestive Surgery, Kita-Harima Medical Center, 926-250, Ichiba-cho, Ono, 675-1392, Japan; Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
Asian Journal of Surgery
|May 3, 2019
Summary
Laparoscopic anatomical liver resections (LALR) using indocyanine green (ICG) fluorescence imaging improve visualization of liver segments. This technique enhances surgical precision for resecting tumors during LALR procedures.
Area of Science:
- Hepatobiliary Surgery
- Minimally Invasive Surgery
- Surgical Oncology
Background:
- Anatomical liver resections are crucial for treating liver malignancies like hepatocellular carcinoma (HCC).
- Laparoscopic anatomical liver resection (LALR) presents challenges in reproducibility and intraoperative visualization of liver segments.
- Indocyanine green (ICG) fluorescence imaging has emerged as a tool to delineate tumors and surgical margins.
Purpose of the Study:
- To describe the application of ICG fluorescence imaging in pure LALR procedures.
- To evaluate the feasibility and effectiveness of ICG in visualizing demarcation lines during LALR.
Main Methods:
- Three patients underwent pure LALR utilizing ICG fluorescence imaging.
- ICG (2.5 mg) was administered intravenously to visualize hepatic perfusion and demarcation lines via negative staining.
- Optical imaging systems were employed to capture ICG fluorescence during surgery.
Main Results:
- ICG fluorescence imaging clearly delineated demarcation lines and intersegmental planes in all cases.
- The tumor-bearing hepatic region appeared as non-fluorescing parenchyma, aiding surgical guidance.
- Surgeons could effectively recognize the direction and guide parenchymal transection during LALR.
Conclusions:
- LALR combined with ICG fluorescence imaging is a feasible approach for liver tumor resection.
- This technique significantly enhances the visualization of demarcation lines and hepatic section boundaries.
- ICG fluorescence imaging improves the precision and safety of laparoscopic liver resections.
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