Advertisement

Identification of Hepatic Segment

  • Masaki UenoEmail author

Abstract

Near-infrared fluorescence (NIRF) imaging with indocyanine green (ICG) is a novel imaging system. This technique is clinically used in sentinel node navigation of breast or foregut cancer, neurovascular or cardiovascular surgery, and liver surgery. In the field of liver surgery, intraoperative segmentation is one of the most beneficial NIRF imaging. In this chapter, counter and direct perfusion methods using NIRF imaging are proposed in order to perform intraoperative hepatic segmentation. With these techniques, we could clearly and continuously depict hepatic segment not only on the surface of the liver but also on the intraparenchymal segmental plane.

Keywords

Hepatic segment Anatomical resection Indocyanine green Near infrared Hepatocellular carcinoma 

Supplementary material

318927_1_En_13_MOESM1_ESM.wmv (10.8 mb)
Video 13.1 A video of right anterior sectionectomy for HCC using counter perfusion method. ICG fluorescence was maintained and navigated resection line during surgery (WMV 11,081 kb)
Video 13.2

A video of segmentectomy VI for HCC using direct perfusion method. ICG fluorescence was clearly maintained at segment VI (WMV 17,385 kb)

References

  1. 1.
    Eguchi S, Kanematsu T, Arii S, et al. Comparison of the outcomes between an anatomical subsegmentectomy and a non-anatomical minor hepatectomy for single hepatocellular carcinomas based on a Japanese nationwide survey. Surgery. 2008;143:469–75.CrossRefPubMedGoogle Scholar
  2. 2.
    Agrawal S, Belghiti J. Oncologic resection for malignant tumors of the liver. Ann Surg. 2011;253:656–65.CrossRefPubMedGoogle Scholar
  3. 3.
    Hasegawa K, Kokudo N, Imamura H, et al. Prognostic impact of anatomic resection for hepatocellular carcinoma. Ann Surg. 2005;242:252–9.PubMedCentralCrossRefPubMedGoogle Scholar
  4. 4.
    Takasaki K, Kobayashi S, Tanaka S, Saito A, Yamamoto M, Hanyu F. Highly anatomically systematized hepatic resection with glissonean sheath code transection at the hepatic hilus. Int Surg. 1990;75:73–7.PubMedGoogle Scholar
  5. 5.
    Makuuchi M, Hasegawa H, Yamazaki S. Ultrasonically guided subsegmentectomy. Surg Gynecol Obstet. 1985;161:346–50.PubMedGoogle Scholar
  6. 6.
    Kusano M, Tajima Y, Yamazaki K, Kato M, Watanabe M, Miwa M. Sentinel node mapping guided by indocyanine green fluorescence imaging: a new method for sentinel node navigation surgery in gastrointestinal cancer. Dig Surg. 2008;25:103–8.CrossRefPubMedGoogle Scholar
  7. 7.
    Troyan SL, Kianzad V, Gibbs-Strauss SL, et al. The flare intraoperative near-infrared fluorescence imaging system: a first-in-human clinical trial in breast cancer sentinel lymph node mapping. Ann Surg Oncol. 2009;16:2943–52.PubMedCentralCrossRefPubMedGoogle Scholar
  8. 8.
    Hirono S, Tani M, Kawai M, et al. Identification of the lymphatic drainage pathways from the pancreatic head guided by indocyanine green fluorescence imaging during pancreaticoduodenectomy. Dig Surg. 2012;29:132–9.CrossRefPubMedGoogle Scholar
  9. 9.
    Raabe A, Beck J, Gerlach R, Zimmermann M, Seifert V. Near-infrared indocyanine green video angiography: a new method for intraoperative assessment of vascular flow. Neurosurgery. 2003;52:132–9. discussion 139.PubMedGoogle Scholar
  10. 10.
    Rubens FD, Ruel M, Fremes SE. A new and simplified method for coronary and graft imaging during cabg. Heart Surg Forum. 2002;5:141–4.PubMedGoogle Scholar
  11. 11.
    Gotoh K, Yamada T, Ishikawa O, et al. A novel image-guided surgery of hepatocellular carcinoma by indocyanine green fluorescence imaging navigation. J Surg Oncol. 2009;100:75–9.CrossRefPubMedGoogle Scholar
  12. 12.
    Ishizawa T, Fukushima N, Shibahara J, et al. Real-time identification of liver cancers by using indocyanine green fluorescent imaging. Cancer. 2009;115:2491–504.CrossRefPubMedGoogle Scholar
  13. 13.
    Morita Y, Sakaguchi T, Unno N, et al. Detection of hepatocellular carcinomas with near-infrared fluorescence imaging using indocyanine green: its usefulness and limitation. Int J Clin Oncol. 2013;18:232–41.CrossRefPubMedGoogle Scholar
  14. 14.
    Aoki T, Yasuda D, Shimizu Y, et al. Image-guided liver mapping using fluorescence navigation system with indocyanine green for anatomical hepatic resection. World J Surg. 2008;32:1763–7.CrossRefPubMedGoogle Scholar
  15. 15.
    Uchiyama K, Ueno M, Ozawa S, et al. Combined intraoperative use of contrast-enhanced ultrasonography imaging using a sonazoid and fluorescence navigation system with indocyanine green during anatomical hepatectomy. Langenbecks Arch Surg. 2011;396:1101–7.CrossRefPubMedGoogle Scholar
  16. 16.
    Kaibori M, Ishizaki M, Matsui K, Kwon AH. Intraoperative indocyanine green fluorescent imaging for prevention of bile leakage after hepatic resection. Surgery. 2011;150:91–8.CrossRefPubMedGoogle Scholar
  17. 17.
    Saito S, Yamanaka J, Miura K, et al. A novel 3d hepatectomy simulation based on liver circulation: application to liver resection and transplantation. Hepatology. 2005;41:1297–304.CrossRefPubMedGoogle Scholar
  18. 18.
    Takamoto T, Hashimoto T, Ogata S, et al. Planning of anatomical liver segmentectomy and subsegmentectomy with 3-dimensional simulation software. Am J Surg. 2013;206:530–8.CrossRefPubMedGoogle Scholar
  19. 19.
    Buell JF, Cherqui D, Geller DA, et al. The international position on laparoscopic liver surgery: the Louisville statement, 2008. Ann Surg. 2009;250:825–30.CrossRefPubMedGoogle Scholar
  20. 20.
    Jafari MD, Lee KH, Halabi WJ, et al. The use of indocyanine green fluorescence to assess anastomotic perfusion during robotic assisted laparoscopic rectal surgery. Surg Endosc. 2013;27:3003–8.CrossRefPubMedGoogle Scholar
  21. 21.
    Cahill RA, Anderson M, Wang LM, Lindsey I, Cunningham C, Mortensen NJ. Near-infrared (nir) laparoscopy for intraoperative lymphatic road-mapping and sentinel node identification during definitive surgical resection of early-stage colorectal neoplasia. Surg Endosc. 2012;26:197–204.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  1. 1.Second Department of SurgeryWakayama Medical UniversityWakayamaJapan

Personalised recommendations