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Updated: Nov 8, 2025
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Laparoscopic Anatomical Hepatectomy Using Takasaki's Approach and Indocyanine Green Fluorescence Navigation
Published on: May 16, 2025
441
Intraoperative guidance using ICG fluorescence imaging system for safe and precise laparoscopic liver resection
Yuichiro Otsuka1, Yu Matsumoto2, Yuko Ito2
1Division of General and Gastroenterological Surgery (Omori), Department of Surgery, Toho University Faculty of Medicine, Tokyo, Japan - yotsuka@med.toho-u.ac.jp.
Minerva Surgery
|April 23, 2021
Summary
Indocyanine green (ICG) fluorescence imaging enhances laparoscopic liver resection (LLR) safety and precision. This technique aids in identifying liver tumors and anatomical structures, improving surgical outcomes in minimally invasive liver surgery.
Area of Science:
- Minimally Invasive Surgery
- Surgical Oncology
- Hepatobiliary Surgery
Background:
- Laparoscopic liver resection (LLR) is an established minimally invasive approach for liver disease.
- Advancements in surgical technology have expanded the scope of LLR procedures.
- Indocyanine green (ICG) fluorescence imaging, previously used in open surgery, is now applicable to LLR.
Purpose of the Study:
- To evaluate the safety and effectiveness of ICG fluorescence imaging during LLR.
- To assess the utility of ICG imaging for tumor detection, anatomical identification, and cholangiography in LLR.
Main Methods:
- A retrospective review of 34 patients undergoing 46 LLR procedures using ICG fluorescence imaging from September 2013 to August 2019.
- ICG imaging was employed for identifying liver tumor nodules (30 cases), defining liver anatomical domains (12 cases), and performing intraoperative cholangiography (4 cases).
Main Results:
- ICG imaging successfully detected 83.3% (25/30) of liver tumors, including benign and low-grade malignant types.
- Anatomical domain identification was successful in all 12 cases.
- Intraoperative cholangiography was successful in all 4 cases, with one instance of biliary leakage successfully repaired.
Conclusions:
- ICG fluorescence imaging is a valuable tool for enhancing the safety and precision of LLR.
- The technique facilitates accurate tumor localization, anatomical delineation, and biliary structure visualization during LLR.
