Minimally invasive surgery for CRLM located in the postero-superior segments. The advantages of preoperative ICG injection in tumour detection during liver transection

Introduction: Laparoscopic liver resection (LLR) can be challenging for tumors located in the posterior-segments due to difficult access and reduced view. However use of preoperative ICG injection tumor detection together with intraoperative US, might help overcome difficulties. Indeed, fluorescence during could guide surgeons follow a proper transection line. This tool may ensure safety oncological efficiency, particular when major vessels should spared avoid resections such kind recurrence tendency. Method: The aim this video is present technical aspects usefulness Indocyanine Green Fluorescence (ICG) prior surgery LLR segments VII-VIII large colorectal metastasis (CRLM). Results: patient was male 56 years old man synchronous (90 mm) VII-VIII. Medical history: left hemicolectomy atypical gastric adenocarcinoma (T4aN1bM1, K-Ras wild-type, BRAF -). Patient underwent 4 chemotherapy cycles FOLFOX were performed down-stage metastasis. performed; injected days (0.5 mg/kg). used better detect line especially where lesion got attached dorsal VIII glissonian pedicle. Histology reported (75 mm), R1 vascular (Parenchymal margin 7 mm). Operative time 290 min, blood loss 200 cc. Hospital stay no complications. Conclusion: Preoperative an additional helpful assist more precisely line, ensuring