World Journal of Surgery

, Volume 43, Issue 5, pp 1308–1312 | Cite as

Efficacy of Hepatic Segmental Visualization Using Indocyanine Green Photodynamic Eye Imaging

  • Atsushi NanashimaEmail author
  • Koichi Yano
  • Shuichi Tobinaga
Original Scientific Report with Video



To clarify the usefulness of identification of hepatic segmentation stained with an indocyanine green–photodynamic eye (ICG–PDE) system, we sequentially investigated the matching of visualization during hepatectomy in 40 patients at two institutions between 2009 and 2017.


A low dose of ICG was administered into the portal flow to stain the estimated segments of the liver to be resected during hepatectomy, and segmentation images were observed using a PDE camera. Intraoperative ICG–PDE could be carried out for all patients without side effects.


Complete segmental identification of the liver by blue dye stain and ICG–PDE was achieved in 30 (75%) and 35 (88%) patients, respectively, but the prevalence between them was not significantly different (p = 0.302). ICG–PDE segmentation in the estimated area was incomplete in three patients, and complete failure (no staining) was observed in two patients. The border between the posterior section and the caudate was identified in two patients.


This preliminary study showed ICG–PDE to be a useful tool for clearly determining liver segmentation to estimate the area for resection.


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Informed consent

Informed consent for data collection was obtained by the opt-out procedures for 1 month.

Supplementary material

Supplementary material 1 (WMV 3310 kb)


  1. 1.
    Makuuchi M, Mori T, Gunvén P et al (1987) Safety of hemihepatic vascular occlusion during resection of the liver. Surg Gynecol Obstet 164:155–158PubMedGoogle Scholar
  2. 2.
    Hojo T, Nagao T, Kikuyama M et al (2010) Evaluation of sentinel node biopsy by combined fluorescent and dye method and lymph flow for breast cancer. Breast 19:210–213CrossRefGoogle Scholar
  3. 3.
    Nishino H, Hatano E, Seo S et al (2018) Real-time navigation for liver surgery using projection mapping with indocyanine green fluorescence: development of the novel medical imaging projection system. Ann Surg 267:1134–1140CrossRefPubMedGoogle Scholar
  4. 4.
    Uchiyama K, Ueno M, Ozawa S et al (2011) Combined intraoperative use of contrast-enhanced ultrasonography imaging using a sonazoid and fluorescence navigation system with indocyanine green during anatomical hepatectomy. Langenbecks Arch Surg 396:1101–1107CrossRefPubMedGoogle Scholar
  5. 5.
    Kudo H, Ishizawa T, Tani K et al (2014) Visualization of subcapsular hepatic malignancy by indocyanine-green fluorescence imaging during laparoscopic hepatectomy. Surg Endosc 28:2504–2508CrossRefPubMedGoogle Scholar

Copyright information

© Société Internationale de Chirurgie 2019

Authors and Affiliations

  • Atsushi Nanashima
    • 1
    • 2
    Email author
  • Koichi Yano
    • 1
  • Shuichi Tobinaga
    • 2
  1. 1.Division of Hepato-biliary-pancreas Surgery, Department of SurgeryUniversity of Miyazaki Faculty of MedicineMiyazakiJapan
  2. 2.Department of Surgical OncologyNagasaki University Graduate School of Biomedical SciencesNagasakiJapan

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