Dual Techniques for Identifying Intersegmental Planes Using Indocyanine Green and Virtual-Assisted Lung Mapping in...

Area of Science:

• Thoracic Surgery
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Accurate identification of the intersegmental plane is essential for successful robotic segmentectomy.
• Current methods for defining this plane during robot-assisted thoracoscopic surgery (RATS) require further investigation.

Purpose of the Study:

• To evaluate the effectiveness of different techniques for identifying the intersegmental plane during robotic segmentectomy.
• To compare selective segmental inflation-deflation RATS with indocyanine green (ICG) injection with or without virtual-assisted lung mapping (VAL-MAP) RATS.

Main Methods:

• Retrospective analysis of 112 patients undergoing robotic segmentectomy between January 2017 and January 2023.
• Comparison of outcomes between patients who underwent selective segmental inflation-deflation RATS and those who received ICG injection with or without VAL-MAP RATS.

Main Results:

• No significant differences in clinical factors or perioperative outcomes were observed between the groups.
• Complex segmentectomies were more frequent in the ICG with or without VAL-MAP RATS group.
• Dual techniques (ICG and VAL-MAP) were safely used for complex cases, ensuring adequate surgical margins.

Conclusions:

• Dual techniques combining indocyanine green (ICG) injection and preoperative virtual-assisted lung mapping (VAL-MAP) are safe and beneficial for robotic lung segmentectomy.
• These methods enhance the ability to identify intersegmental planes, particularly in complex cases.