• Skip to primary navigation
  • Skip to main content
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Advocacy
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • SAGES Store
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
    • “Unofficial” Logo Products
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2024 Scientific Session Call For Abstracts
      • 2024 Emerging Technology Call For Abstracts
    • CME Claim Form
    • Industry
      • Advertising Opportunities
    • Future Meetings
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • Wellness Resources – You Are Not Alone
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Fellows Career Development Course
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES Top 21 MIS Procedures
    • SAGES Pearls
    • SAGES Flexible Endoscopy 101
    • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • NEW-Area of Concentrated Training Seal (ACT)-Advanced Flexible Endoscopy
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Multi-Society Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • OWLS
  • Log In

ICG immunofluorescence guided pure laparoscopic right hepatectomy for HCC in patient with cirrhosis

Tan To Cheung, MS. The Universtiy of Hong Kong Queen Mary Hospital

Background: The advantages of laparoscopic liver resection become more obvious as evidence on its long term outcome has emerged. Compared to open resection, there is no difference in term of overall survival. During laparoscopic liver resection, surgeons cannot use their tactile sensation to feel the liver and to evaluate the margin from the tumour. ICG immuofluoresence navigation is a new method to provide a visualisation of the tumor on display screen during the operation.

This video will demonstrate the use of pure laparoscopic right hepatectomy for a patient with right lobe HCCs.

Method: The patient was a 50-year-old gentlemen who had chronic hepatitis B infection. He was found to have a 5cm tumor in the right lobe of the liver and one 1cm suspicious lesion in the S8 of the liver by contrast CT scan.

His platelet count was only 111×10^9/L. His bilirubin level was 25umol/L, albumin level was 37g/L. The preoperative ICG retention at 15 minutes was 8%.

Pure laparoscopic right hepatectomy was performed as shown in the video.

0.5mg/kg of ICG was administrated to patient 1 day before operation. The Tumor and suspected lesions were directly visualized during the procedure. The hepatic right hepatic artery and right portal vein were controlled and divided individually and the right bile duct was divided. Liver parenchymal transection was performed using the energy device and CUSA. The right hepatic vein was divided by vascular stapler. Intracoporal suture was performed to control the bleeding from hepatic vein stump.

Result: The operation last for 280 minutes. Blood loss was 300ml and no blood transfusion was required. He resumed diet on the next day and was discharged 4 days after the operation. He has good liver function before discharge and at 7 days, 1 month and 3 months after operation. The pathology showed a 5cm moderately differentiated HCC in the right lobe, the S8 lesion was a dysplastic nodule. Contrast CT scan was arranged at one month and every three months interval after the operation according to our protocol and no recurrence was found.

Conclusion: Pure laparoscopic right hepatectomy is safe option even for patients with HCC.

The use of ICG immunofluorescence system is a useful adjunct to complicated laparoscopic liver resection. It is sensitive in picking up lesion and aid the surgeons in visualising the lesions without touching it.

130

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

Hours & Info

11300 West Olympic Blvd, Suite 600
Los Angeles, CA 90064
1-310-437-0544
[email protected]
Monday - Friday
8am to 5pm Pacific Time

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube
  • Instagram
  • TikTok

Important Links

SAGES 2024 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2023 Society of American Gastrointestinal and Endoscopic Surgeons