Fluorescence-Guided Thoracoscopic Surgery Using Indocyanine Green (ICG) in Canine Cadavers: A Descriptive Evaluation...

Area of Science:

• Veterinary Surgery
• Minimally Invasive Surgery
• Surgical Imaging

Background:

• Intraoperative identification of the canine thoracic duct is difficult due to anatomical variations and poor visualization.
• Minimally invasive surgical techniques require precise anatomical mapping for successful outcomes.

Purpose of the Study:

• To evaluate the feasibility of fluorescence-guided thoracic duct mapping using video-assisted thoracoscopy (VATS) and robot-assisted thoracoscopy (Versius™ system) in canine cadavers.
• To quantitatively assess fluorescence imaging quality for thoracic duct visualization.

Main Methods:

• Four adult Beagle cadavers underwent bilateral thoracoscopic exploration.
• Intranodal injection of indocyanine green (ICG) followed by near-infrared (NIR) fluorescence imaging.
• Quantitative analysis of fluorescence quality using signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and contrast resolution (CR).

Main Results:

• Both VATS and robotic-assisted thoracoscopy successfully identified the thoracic duct and its branches in all cadavers.
• VATS demonstrated brighter fluorescence, while robotic-assisted surgery provided stable imaging and better duct-to-background discrimination.
• Quantitative optical parameters were calculated to standardize imaging quality assessment.

Conclusions:

• Fluorescence-guided thoracic duct identification is feasible using both VATS and robotic-assisted thoracoscopy in canine cadavers.
• The proposed standardized assessment of optical parameters can aid future in vivo studies.
• This technique holds potential for improving thoracic duct surgery in dogs.