Infrared thoracoscopic pulmonary segmentectomy with intravenous indocyanine green administration using preoperative simulation. (30th December 2021) - Igai, Hitoshi
Abstract: Infrared thoracoscopy with intravenous indocyanine green administration is one of the useful methods to identify an appropriate intersegmental line during thoracoscopic pulmonary segmentectomy. In this procedure, we have introduced preoperative simulation to calculate the distance between the target tumour and intersegmental plane using Ziostation2 (Ziosoft, Tokyo, Japan) to ensure sufficient surgical margin without palpation. By using this preoperative simulation, we obtained sufficient surgical margin in a patient with a 16-mm part-solid nodular shadow undergoing infrared thoracoscopic upper division (S1–3) segmentectomy of left upper lobe with intravenous indocyanine green administration. The discrepancy between the virtual and the actual surgical margin was <10 mm. This preoperative simulation can help us obtain sufficient surgical margin without palpation of the tumour in infrared thoracoscopic segmentectomy. Abstract : Although it is most important to ensure sufficient surgical margin during pulmonary segmentectomy for malignant disease, in thoracoscopic approach, it is sometimes difficult for a surgeon to recognize it without palpation of the tumour when the tumour is invisible on monitor.