Indocyanine Green (ICG) Guided Robotic Assisted Left Hemihepatectomy

Roland Croner, MD, FACS

Product Details
Product ID: ACS-6118
Year Produced: 2020
Length: 6 min.


Robotic liver resection is a new minimally invasive procedure which has been reported as save technique for liver surgery. Indocyanine green (IGC) has various implications in liver surgery. Tumors and bile ducts can be visualized and liver perfusion can be controlled. We combined both techniques for robotic assisted major liver resection. A 68 year old male patient suffered from HCC in the left liver. No distant metastases were identified during staging procedure. The patient underwent appendectomy before several years only and no other abdominal surgery. He was selected for robotic assisted left hemihepatectomy. Informed consent was obtained from the patient. The trokar placement with additional trokars for pringle maneuvere and assistance and the docing of the robot via the right shoulder of the patient as described previously is an adequate setting for this operation. The patient received ICG intravenously after inflow dissection of the left liver. An anatomical demarcation of the left and right liver occurred which made anatomical hemihepatectomy possible in a precise way. Estimated blood loss was 400ccl. The specimen showed a R0 situation with 1 cm margin to the tumor. The patient recovered without any postoperative morbidity and was discharged on postoperative day 8. IGC guided major liver resection is a save procedure which enables the identification of the anatomical landmarks between the right and left liver. This makes a safe parenchymal dissection with low blood loss possible and reduces the risk of remaining non perfused liver tissue.