IndoCyanine Green fluorescence guided resections in hepatobiliary surgery

Background: Fluorescence-guided surgery (FGS) has recently gained popularity as a promising technique for treating visceral, hepatobiliary, and pancreatic neoplasms. It involves using laser sources to illuminate injected substances that emit a fluorescence signal, guiding surgical procedures, and providing real-time visualization of otherwise undetectable structures. This review explores the advancements in hepatobiliary surgery using IndoCyanine Green (ICG) fluorescence guided resections. Methods: The review examined the use of FGS in identifying subcapsular liver tumors, millimetric hepatocellular carcinoma, intrahepatic cholangiocarcinoma, liver metastases, and various benign liver neoplasms. In addition, fluorescence cholangiography using ICG injection was explored to improve liver surgery's accuracy and safety. Results: The review found that ICG fluorescence-guided resections can potentially improve surgical outcomes by enhancing the accuracy and safety of procedures. The use of fluorescence cholangiography allows for the efficient identification of the bile ducts and helps surgeons avoid damaging critical structures during liver surgery. Conclusion: ICG fluorescence-guided resections represent a promising method for improving surgical outcomes and patient safety for visceral and hepatobiliary Surgery. It is a quick, easy, inexpensive, and safe device that can be used for various surgical applications. As imaging systems continue to improve, fluorescence imaging can become a widely used intraoperative navigation tool for open, laparoscopic, and robotic surgery.