Article ID: JNMS.2019_86-503
The indocyanine green (ICG) fluorescence method is reportedly useful for intraoperative visualization of hepatocellular carcinoma and metastatic liver cancer. Herein, we report the case of a 73-year-old man who underwent laparoscopic hepatectomy using an ICG fluorescence navigation system. The patient had 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, and so the patient was hospitalized for surgery. Because of his surgical history, adhesions within the abdominal cavity were predicted. We scheduled laparoscopic repeat hepatectomy (LRH) using an ICG fluorescence method in which the ICG was injected intravenously 2 days before surgery. The ICG fluorescence was easily detected intraoperatively. The advantages of the present approach were: 1) inducing pneumoperitoneum and using laparoscopic magnification enabled good visualization of the surgical field for LRH; 2) use of the ICG fluorescence technique enabled clear intraoperative identification of the tumor, thus facilitating LRH. Laparoscopic partial resection of the liver (S3) was successfully performed, with an operation time of 197 minutes and a bleeding volume of 30 mL. The patient had an uneventful postoperative course and was discharged on postoperative day 10.
