Background: Anatomical resections have been reported to achieve better long-term outcomes compared with partial resections for the treatment of hepatocellular carcinoma (HCC). In hepatobiliary surgery, 15-min indocyanine green (ICG) retention rate has been used for decades to evaluate the preoperative liver function. Intraoperatively, fluorescence imaging is useful to identify subcapsular hepatic tumors. Primary and secondary hepatic malignancy can be identified by intraoperative fluorescence imaging using preoperative intravenous injection of ICG. This is achieved by visualizing fluorescence from the area of impaired bile excretion in hepatocellular cancer tissue and in the liver parenchyma surrounding metastatic liver cancers. With the spreading of laparoscopic liver resection (LLR), intraoperative fluorescence imaging may help to detect tumours and to guide the parenchymal dissection.

Methods: In this case a 72-year-old man with incidental diagnosis of liver lesion localized in the left lobe, undergoes laparoscopic liver sectionectomy. Intraoperative ICG fluoroscopy was used to detect the lesion and to control the resection margins.

Results: Operative time was 180 min and blood loss was less than 50 mL. The patient had an uneventful postoperative course and was discharged home after 4 days. At 6 months follow-up the patient has no recurrence.

Conclusions: Laparoscopic left lateral sectionectomy is a commonly perfomed operation in high volume centers for LLR. The use of intraoperative ICG fluoroscopy could be of help, but laparoscopic ultrasound is still necessary to complete this procedure safely.