Detailed Abstract
[Liver Video Exhibition - Liver (Liver Disease/Surgery)]
[LV VE 12] LAPAROSCOPIC ICG GUIDED SEGMENTAL LIVER RESECTION
K. VIJAYA KUMAR 1, RAJIV MAHARAJ 1, Y. RAGHU NANDAN 1, N. ANAND VIJAI 1, V.P NALANKILLI 1, P. SENTHILNATHAN 1, C. PALANIVELU 1
1 Division of HPB, Minimal Access Surgery And Liver Transplant, GEM HOSPITAL AND RESEARCH INSTITUTE,COIMBATORE, INDIA
Background : Laparoscopic ICG guided segmental liver resection , promising approach for accurate tumor localization and precise surgical margins. In this vedio ,we present 5 cases of ICG Guided Segmental liver resections.
Methods : Case 1-33 yr female presented with Malignant ovarian Germ cell tumor and Segment 2 liver Mets, down staged with neoadjuvant chemotherapy. Negative staining after clamping segment 2 portal pedicle and ICG guided Segment 2 Laparoscopic liver resections done. Case 2- 64 yr male ,post Right hemicolectomy for Cecal cancer on adjuvant therapy developed segment 4a metastasis on follow up. Underwent Non anatomical resection ,again developed Recurrent lesion. Using Negative staining ICG guided segment 4a laparoscopic resection was done. Case 3-64yr female tumor in caudate lobe underwent ICG guided caudate lobe excision after clamping caudate lobe inflow pedicle and negative staining with ICG. Case 4-70 yr old male ,HCC, Segment 4a ,ICG given 72 hrs preoperatively and ICG guided segmental resection was done. Case 5-67 yr old male with HCV cleated cirrhosis, 3 cm tumor in segment 7 ,underwent segmental liver resection after injecting ICG dye 72 hours preoperatively. IOUS was used in all cases .Superficial parenchymal transection done with Ultrasonic shears. Deeper transection was done with Laparoscopic CUSA and Bipolar.
Results : All five patients postoperative recovery was good . 1 patient had bleeding from cut surface which was managed with blood transfusion. All resection margins are negative.
Conclusions : ICG guided Laparoscopic segmental resection with both positive and negative staining technique gives precise localization and margin negative resection even difficult locations of liver.
Methods : Case 1-33 yr female presented with Malignant ovarian Germ cell tumor and Segment 2 liver Mets, down staged with neoadjuvant chemotherapy. Negative staining after clamping segment 2 portal pedicle and ICG guided Segment 2 Laparoscopic liver resections done. Case 2- 64 yr male ,post Right hemicolectomy for Cecal cancer on adjuvant therapy developed segment 4a metastasis on follow up. Underwent Non anatomical resection ,again developed Recurrent lesion. Using Negative staining ICG guided segment 4a laparoscopic resection was done. Case 3-64yr female tumor in caudate lobe underwent ICG guided caudate lobe excision after clamping caudate lobe inflow pedicle and negative staining with ICG. Case 4-70 yr old male ,HCC, Segment 4a ,ICG given 72 hrs preoperatively and ICG guided segmental resection was done. Case 5-67 yr old male with HCV cleated cirrhosis, 3 cm tumor in segment 7 ,underwent segmental liver resection after injecting ICG dye 72 hours preoperatively. IOUS was used in all cases .Superficial parenchymal transection done with Ultrasonic shears. Deeper transection was done with Laparoscopic CUSA and Bipolar.
Results : All five patients postoperative recovery was good . 1 patient had bleeding from cut surface which was managed with blood transfusion. All resection margins are negative.
Conclusions : ICG guided Laparoscopic segmental resection with both positive and negative staining technique gives precise localization and margin negative resection even difficult locations of liver.
SESSION
Liver Video Exhibition
Video Exhibition 3/21/2024 12:00 AM - 12:00 AM