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Indocyanine green segmentectomy

Pier Cristoforo Giulianotti, Francesco Maria Bianco, Despoina Daskalaki, Luis Fernando Gonzalez-Ciccarelli, Jihun Kim, Enrico Benedetti
Minimally invasive surgery for liver resections has a defined role and represents an accepted alternative to open techniques for selected cases. Robotic technology can overcome some of the disadvantages of the laparoscopic technique, mainly in the most complex cases. Precise dissection and microsuturing is possible, even in narrow operative fields, allowing for a better dissection of the hepatic hilum, fine lymphadenectomy, and biliary reconstruction even with small bile ducts and easier bleeding control. This technique has the potential to allow for a greater number of major resections and difficult segmentectomies to be performed in a minimally invasive fashion...
August 2016: Hepatobiliary Surgery and Nutrition
Shintaro Tarumi, Hiroyasu Yokomise
The maintenance of a good surgical view is mandatory in video-assisted thoracoscopic surgery (VATS). For routine segmentectomy, it is necessary to re-inflate the lung in order to identify the intersegmental borders. However, such re-inflation can occasionally obstruct the surgical view and can lead to prolongation of operation time, particularly in the context of VATS. Infrared thoracoscopy( IRT) with indocyanine green (ICG) is a new method of evaluating lung perfusion. There are 2 methods in IRT. One is based on ICG absorption, and the other is based on ICG fluorescence...
July 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Hiroaki Kuroda, Hitoshi Dejima, Tetsuya Mizumo, Noriaki Sakakura, Yukinori Sakao
BACKGROUND: The purpose of this study was to present a new approach to the formation of a segmental plane by LigaSure (Covidien, Mansfield, MA, USA) with indocyanine green (ICG) fluorescence system during thoracoscopic segmentectomy. METHODS: This was a consecutive study that compared 12 patients who underwent a new LigaSure technique (LT) for segmental plane formation during thoracoscopic anatomical segmentectomy with 38 patients who underwent conventional methods using the staple technique (ST)...
June 2016: Journal of Thoracic Disease
Shuhei Iizuka, Hiroaki Kuroda, Kenichi Yoshimura, Hitoshi Dejima, Katsutoshi Seto, Akira Naomi, Tetsuya Mizuno, Noriaki Sakakura, Yukinori Sakao
BACKGROUND: To determine factors predicting indocyanine green (ICG) visualization during fluorescence imaging for segmental plane formation in thoracoscopic anatomical segmentectomy. METHODS: Intraoperatively, the intravenous ICG fluorescence imaging system during thoracoscopic anatomical segmentectomy obtained fluorescence emitted images of its surfaces during lung segmental plane formation after the administration of 5 mg/body weight of ICG. The subtraction of regularization scale for calculating the exciting peaks of ICG between the planned segments to resect and to remain was defined as ΔIntensity (ΔI)...
May 2016: Journal of Thoracic Disease
Hiroaki Nomori, Yue Cong, Hiroshi Sugimura
PURPOSES: Sentinel node identification using indocyanine green (ICG) is not only simpler, but also more cost-effective, than using radioisotope tracers. We herein examined the utility and pitfalls of sentinel node (SN) identification using ICG during segmentectomy in patients with cT1N0M0 non-small cell lung cancer (NSCLC). METHODS: ICG was injected around the tumor after thoracotomy, followed by segmentectomy and lymph node dissection, in 135 patients with cT1N0M0 NSCLC...
August 2016: Surgery Today
Yujin Oh, Yu Hua Quan, Minji Kim, Beop-Min Kim, Hyun Koo Kim
BACKGROUND: The intraoperative color and fluorescence-merged imaging system (ICFIS) is a new technology that may aid the demarcation of intersegmental borders during pulmonary segmentectomy. This study was performed to validate, for the first time, image-guided segmentectomy using ICFIS and to find the optimal dosage of fluorescent dye to ensure safe and sustained imaging during surgery. METHODS: Nine rabbits were subjected to pulmonary segmentectomy. These constituted three groups of three rabbits each...
December 2015: Journal of Surgical Research
Masahiko Sakoda, Shinichi Ueno, Satoshi Iino, Kiyokazu Hiwatashi, Koji Minami, Yota Kawasaki, Hiroshi Kurahara, Yukou Mataki, Kousei Maemura, Yoshikazu Uenosono, Hiroyuki Shinchi, Shoji Natsugoe
PURPOSE: It is important to minimize surgical invasiveness in the therapy of patients with hepatocellular carcinoma (HCC), and consequently laparoscopic hepatic resection is widely performed. However, most anatomical resections, except left lateral sectionectomy, remain difficult technically, and laparoscopy-assisted procedures have been introduced as an alternative approach because of the safety and curative success of the operation. We reported previously pure laparoscopic subsegmentectomy of the liver using puncture of the portal branch under percutaneous ultrasound (US) with artificial ascites...
December 2014: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Yoshitaka Kasai, Hiroyasu Yokomise
Infrared thoracoscopy with indocyanine green (ICG) is a new method of evaluating lung perfusion. We succeeded in visualizing lung emphysematous lesions and intersegmental borders using infrared thoracoscopy with ICG in animals, and within clinical investigations. There are 2 methods in infrared thoracoscopy. One is the 2-wavelength method, and the other is the 1-wavelength method. The 2- wavelength method is based on ICG absorption, and the 1-wavelength method is based on ICG fluorescence. The 2-wavelength method is superior for the clarity of images...
July 2014: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Hiromitsu Takizawa, Shoji Sakiyama
Sentinel node identification is important for small-sized non small cell lung cancer patients who are candidates for segmentectomy in determining their eligibilities. Intraoperative sentinel node identification using indocyanine green or preoperative computed tomography lymphography by transbronchial injection of iopamidol are suitable for daily medical practices, because these methods take about only 10 minutes to identify sentinel nodes in addition to routine surgical or bronchoscopic procedures.
July 2014: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Alessandro Pardolesi, Giulia Veronesi, Piergiorgio Solli, Lorenzo Spaggiari
No abstract text is available yet for this article.
August 2014: Journal of Thoracic and Cardiovascular Surgery
Shintaro Tarumi, Noriyuki Misaki, Yoshitaka Kasai, Sung Soo Chang, Tetsuhiko Go, Hiroyasu Yokomise
OBJECTIVES: The maintenance of a good surgical view is mandatory in video-assisted thoracoscopic surgery (VATS). For routine segmentectomy, it is necessary to re-inflate the lung in order to identify the intersegmental line. However, such re-inflation can occasionally obstruct the surgical view. Infrared thoracoscopy (IRT) with indocyanine green (ICG) can reveal the intersegmental line based on blood flow differences, without the need for lung re-inflation. The purpose of this study was to confirm the usefulness of IRT with ICG for VATS...
July 2014: European Journal of Cardio-thoracic Surgery
Tsuyoshi Ohno, Keiji Inoue, Shigeki Nagayoshi, Toshio Fukuda, Junji Irie
A 44-year-old woman was referred to our hospital with pathological nipple discharge from her left breast. Ultrasonography revealed a solid tumor beneath her left areola that measured 17 mm in diameter with a dilated mammary duct. Contrast-enhanced magnetic resonance imaging showed an early-enhanced cystic tumor and a dilated mammary duct. We performed a duct-lobular segmentectomy using near-infrared indocyanine green (ICG)-fluorescence imaging. Under general anesthesia, a silicone tube was inserted into an orifice of a fluid-discharging mammary duct, and 1 mL dye-fluorescence liquid containing ICG and indigo carmine was injected into the mammary duct...
October 2013: Asian Journal of Surgery
Shiaki Oh, Kenji Suzuki, Yoshikazu Miyasaka, Takeshi Matsunaga, Yukio Tsushima, Kazuya Takamochi
One of the most difficult aspects of complete segmentectomy of the lung is the identification of the intersegmental plane. Instead of a conventional residual segment inflation method, we have developed a new technique for detecting intersegmental planes using indocyanine green medium. The technique is simple and consists of (1) ligation of the segmental vein to prevent loss of the indocyanine green and (2) injection of indocyanine green through the segmental bronchus. These two steps result in easy identification of intersegmental planes by a change of color not only of the surface but also of the parenchyma of the lung...
June 2013: Annals of Thoracic Surgery
Keitaro Matsumoto, Isao Sano, Hideki Taniguchi, Naoya Yamasaki, Tomoshi Tsuchiya, Takuro Miyazaki, Koichi Tomoshige, Takeshi Nagayasu
Localized emphysema is difficult to detect on normal thoracoscopy. Indocyanine green (ICG) was used to precisely delineate an emphysematous lesion using an infrared camera system in a 75-year-old woman with a large emphysematous lesion in the right lower lobe. Due to repeated infections of the emphysematous lesion, right basal segmentectomy for localized lung emphysema was performed. During surgery, ICG (0.5 mg/kg) was injected intravenously, and the emphysematous lesion was detected as a fluorescence defect...
2013: Journal of Cardiothoracic Surgery
Yoshitaka Kasai, Shintaro Tarumi, Sung Soo Chang, Noriyuki Misaki, Masashi Gotoh, Tetsuhiko Go, Hiroyasu Yokomise
OBJECTIVES: Infrared thoracoscopy is a new method of identifying lung intersegmental borders. This study compared the efficacy of 2- and 1-wavelength infrared thoracoscopy. METHODS: A total of 30 consecutive patients who underwent segmentectomy were evaluated by these methods (2-wavelength method, 10 patients; 1-wavelength method, 20 patients). We ligated the dominant pulmonary artery and then observed the lung using an infrared thoracoscope after indocyanine green (ICG) intravenous injection...
December 2013: European Journal of Cardio-thoracic Surgery
Keun Soo Ahn, Koo Jeong Kang, Tae Jun Park, Yong Hoon Kim, Tae Jin Lim, Jung Hyeok Kwon
BACKGROUND: Systematic segmentectomy is useful in treating small hepatocellular carcinoma in the cirrhotic liver. However, accomplishment of an exact systematic segmentectomy still remains a challenging procedure because of the variable anatomy of portal branches. We evaluated the usefulness of the dye injection method for systematic segmentectomy, which focuses on the various patterns of portal vein (PV) branches feeding the tumor. METHODS: From January 2001 to May 2011, systematic segmentectomy by the dye injection method was performed in 70 patients...
December 2013: Annals of Surgery
Toshiro Masuda, Toru Beppu, Shigeki Nakagawa, Hirohisa Okabe, Akira Chikamoto, Tatsunori Miyata, Kosuke Mima, Ryu Otao, Hiromitsu Hayashi, Koichi Doi, Takatoshi Ishiko, Hiroshi Takamori, Hideo Baba
BACKGROUND/PURPOSE: The indications for hepatic resection for hepatocellular carcinoma (HCC) patients with total bilirubin (T-Bil) equal to or higher than 1.2 mg/dl remain controversial. The aim of this study was to investigate the safety of hepatic resection for HCC patients who showed high T-Bil (≥1.2 mg/dl) with low direct bilirubin (D-Bil ≤ 0.5 mg/dl). METHODS: Thirty-four HCC patients showing high T-Bil with low D-Bil were treated with mono- to tri-segmentectomy between January 2000 and December 2010...
March 2013: Journal of Hepato-biliary-pancreatic Sciences
Yasuo Sekine, Eitetsu Ko, Hideto Oishi, Mitsuharu Miwa
OBJECTIVE: Pulmonary segmentectomy has been recognized as an operative option for complete resection of early-stage lung cancer in patients with poor pulmonary function. However, identification of anatomic pulmonary segments is sometimes difficult in patients with emphysema. We developed an intraoperative method for identifying intersegmental planes of the lung with high-sensitivity infrared fluorescence imaging after transbronchial injection of indocyanine green. METHODS: The study included 10 patients with early-stage lung cancer who underwent thoracoscopic segmentectomy...
June 2012: Journal of Thoracic and Cardiovascular Surgery
Shin-ichi Yamashita, Keita Tokuishi, Michiyo Miyawaki, Kentaro Anami, Toshihiko Moroga, Shinsuke Takeno, Masao Chujo, Satoshi Yamamoto, Katsunobu Kawahara
PURPOSE: The application of sentinel node navigation surgery in non-small cell lung cancer (NSCLC) is not popular because of the difficulty of sentinel node identification and the low incidence of complications after systemic lymph node dissection. We report the intraoperative assessment of sentinel node metastasis by thoracoscopic ICG fluorescence imaging system and real-time reverse transcription-polymerase chain reaction (RT-PCR). METHODS: Sixty-one patients who underwent surgery between January 2009 and December 2010 were investigated for sentinel node biopsy...
March 2012: Annals of Surgical Oncology
Toshihiko Moroga, Shin-ichi Yamashita, Keita Tokuishi, Michiyo Miyawaki, Kentaro Anami, Satoshi Yamamoto, Katsunobu Kawahara
OBJECTIVES: Segmentectomy is the treatment of choice for small-sized non-small cell lung cancer (NSCLC); however, it is difficult to decide the surgical procedure because accurate evaluation of hilar lymph node metastasis remains unclear. We here report the outcome of video-assisted thoracic surgery (VATS) segmentectomy with and without the assessment of sentinel nodes. MATERIALS AND METHODS: Eighty-three patients with stage IA NSCLC underwent VATS segmentectomy between January 2003 and December 2010...
2012: Annals of Thoracic and Cardiovascular Surgery
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