Use of indocyanine green in thoracic surgery: a literature review

Indocyanine green (ICG) is a fluorescent dye used for near-infrared (NIR) intraoperative imaging. In thoracic surgery, it is used to delineate intersegmental planes during anatomical segmentectomy, localizing small, nonpalpable lung lesions, assessing gastric conduit perfusion before esophageal anastomosis, and identifying the thoracic duct. A review of the latest literature (2020-2025) indicates that ICG significantly increases the precision of segmentectomy (allowing visualization of the intersegmental plane) and the effectiveness of lung nodule localization (> 95%), as well as enabling objective assessment of tissue perfusion in esophageal surgery (reduction of anastomotic leakage) and facilitating identification and management of thoracic duct injuries. The fluorescence technique with ICG has a favourable safety profile. Indocyanine green is currently a valuable complement to standard methods, increasing the predictability and effectiveness of minimally invasive procedures in the thoracic region.