Positive Staining of Hepatic Segment Using Fluorescent Imaging Techniques During Laparoscopic Hepatectomy

The portal branch toward segment IV is punctured with a 22-gauge spinal needle introduced through the abdominal wall and guided via a standard hole on the flexible laparoscopic ultrasonographic probe. Indocyanine green (0.025 mg in 10 mL of normal saline) is injected into the portal branch, and the liver surface of segment IV starts to show fluorescence of indocyanine green. Fluorescent imaging also shows a metastatic tumor located in the cranial end of segment IV as a nonfluorescing region because indocyanine green is not taken up by metastatic cancer tissue.