Related Experiment Video
Updated: Dec 25, 2025
Application of Indocyanine Green Fluorescence Imaging Technology in Laparoscopic Duodenum-Preserving Pancreatic Head Resection
Published on: November 21, 2025
Near-infrared fluorescence-guided surgery using indocyanine green facilitates secure infrapyloric lymph node
Shin-Hoo Park1, Felix Berlth1,2, Jong-Ho Choi1
1Department of Surgery, Seoul National University College of Medicine, 101 Daehark-ro, Jongno-gu, Seoul, 03080, Korea.
Purpose:
We aimed to investigate the usefulness of near-infrared indocyanine green (ICG)-enhanced fluorescence guidance for infrapyloric LN dissection in laparoscopic distal gastrectomy.
Methods:
This study enrolled patients with early gastric cancer scheduled for laparoscopic distal gastrectomy. After intraoperative submucosal injection of ICG (0.1 mg/mL), LN dissection was conducted under near-infrared ICG fluorescence guidance. The operation time, bleeding events during infrapyloric LN dissection were analyzed. Cases were retrospectively 1:3 propensity-score matched to patients who underwent laparoscopic distal gastrectomy without ICG injection.
Results:
The mean time from midline omentectomy to exposure of the right gastroepiploic vein was significantly shorter in the ICG group (n = 20) than in the non-ICG group (n = 60) (13.05 ± 5.77 vs 18.68 ± 7.92 min; p = 0.001), and the incidence of bleeding during infrapyloric LN dissection was lower in the ICG group (20% vs 68.3%, p < 0.001). The two groups did not differ significantly regarding the number of LNs retrieved from the infrapyloric area (p = 0.434).
Conclusions:
Near-infrared ICG fluorescence guidance facilitates safe and fast infrapyloric LN dissection in laparoscopic distal gastrectomy.
