Indocyanine Green( ICG) Fluorescence Imaging to Visualize Intersegmental Plane

: Early stage lung cancers which localized in the middle layer or the center of the lung become indications for anatomical segmentectomy. As a method of intraoperative identifying the intra-segmental plane, 2 different techniques utilizing indocyanine green (ICG) fluorescence has been clinically applied. The one is a method of systemically intravenous administration of ICG after ligating the objective segmental pulmonary artery. The other is a method of insufflate the diluted ICG into the objective segmental bronchus under the bronchoscope. The segmental alveoli were visualized with a ICG fluorescence thoracoscope. Both methods visualize inter-segmental plane. Both advantages and disadvantages were discussed. These methods may help the repertoire of atypical segmentectomy getting wider. Also, ICG fluorescence imaging is incorporated into a robotic surgery. ICG fluorescence imaging is expected to be applied to various applications of thoracic surgery.