-Case Reports-

Laparoscopic Repeat Hepatectomy with Indocyanine Green Fluorescence Navigation: A Case Report

Masato Yoshioka¹, Nobuhiko Taniai², Youichi Kawano³, Tetsuya Shimizu¹, Ryota Kondo¹, Yohei Kaneya¹, Yuto Aoki¹ and Hiroshi Yoshida¹

¹Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School Hospital
²Department of Gastroenterological Surgery, Nippon Medical School Musashi Kosugi Hospital, Kanagawa, Japan
³Department of Gastroenterological Surgery, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan

The indocyanine green (ICG) fluorescence method is reportedly useful for intraoperative visualization of hepatocellular carcinoma and metastatic liver cancer. Herein, we report the use of an ICG fluorescence navigation system for laparoscopic hepatectomy. The patient was a 73-year-old man with a surgical history of two laparotomies for hepatocellular carcinoma resection. During follow-up at our hospital, abdominal computed tomography revealed recurrence of hepatocellular carcinoma in the lateral area of the liver, after which the patient was hospitalized for surgery. His surgical history indicated that adhesions in the abdominal cavity were likely. We scheduled laparoscopic repeat hepatectomy (LRH) with an ICG fluorescence method in which ICG dye was injected intravenously 2 days before surgery. ICG fluorescence was easily detected intraoperatively. The advantages of the present approach are that it induces pneumoperitoneum and, with laparoscopic magnification, enables good visualization of the surgical field for LRH and clear intraoperative identification of the tumor, thus facilitating LRH. Laparoscopic partial resection of the liver (S3) was successfully performed; the operation time was 197 minutes and bleeding volume was 30 mL. Postoperative course was uneventful and he was discharged on postoperative day 10.

J Nippon Med Sch 2019; 86: 291-295

Keywords
laparoscopic repeat hepatectomy, indocyanine green (ICG), fluorescence navigation

Correspondence to
Masato Yoshioka, MD, PhD, Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School Hospital, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
y-masato@nms.ac.jp

Received, December 4, 2018
Accepted, April 9, 2019