Recently, Surgical Endoscopy, an international authoritative journal in the field of surgery, published online the latest clinical research results of Prof. Yuan Yufeng’s team from the Department of Hepatobiliary and Pancreatic Surgery, Zhongnan Hospital of Wuhan University, which indicates ICG fluorescence imaging guidance could be used for the safe implementation of laparoscopic right posterior hepatectomy. The paper is entitled Indocyanine Green Fluorescence Imaging-Guided Laparoscopic Right Posterior Hepatectomy.
Recent years have witnessed the rapid development of minimally invasive surgery represented by laparoscopic technology. However, since the surgeon can only visually observe the location of the lesion, it was very difficult to accurately locate some deep lesions, which directly affected the quality and even the result of the operation. Fortunately, a solution has been found, which requires ICG, a near-infrared (NIR) fluorescent dye. After being injected into the body, it combines with Human Serum Albumin. Then it is taken up by hepatocytes and excreted by the biliary system. Under the irradiation of an external light source with a wavelength of 750-810nm, it can produce near-infrared light through tissues. The structure of the liver and gallbladder can be displayed through a special receiving device. In normal liver tissues, ICG can be excreted through the hepatobiliary system within 12-24 hours. In the case of liver tumors, the corresponding biliary excretion function is impaired and ICG remains in the lesions, which are shown by fluorescence imaging devices during the operation. In addition, injecting ICG through the portal vein of the target hepatic segments during the operation, or the peripheral vein after blocking the portal vein can achieve the positive or negative tone development of the target hepatic segments; the characteristics of ICG’s excretion through the biliary can also be used to achieve intraoperative cholangiography. The above-mentioned methods could be helpful for the precise implementation of laparoscopic right posterior hepatectomy.
Based on the unique biological characteristics of ICG, Prof. Yuan’s team has conducted in-depth and systematic research on its application in hepatobiliary surgery, especially the timing, dose, concentration and route of ICG injection during ICG fluorescence-guided laparoscopic hepatobiliary surgery. The team also published a series of papers, which were cited in many guidelines and by expert consensus. In the latest published findings, Prof. Yuan’s team applied ICG fluorescence navigation technology to laparoscopic right posterior hepatic surgery to obtain the accurate position of liver tumors and right posterior of the liver. At the same time, they used their own laparoscopic surgical instruments to further optimize the operation, which significantly decreased the risk of the operation and shortened the operative time.
In recent years, Prof. Yuan Yufeng’s team has focused on the application of minimally invasive technology in the diagnosis and treatment of hepatobiliary and pancreatic diseases. The team has done a series of research and development of the capture technology of circulating tumor cells and minimally invasive surgical instruments, as well as the innovation and application of minimally invasive surgical technology. In February 2021, Zhongnan Hospital of Wuhan University was approved as "Hubei Province Clinical Research Center for Hepatobiliary and Pancreatic Disease Minimally Invasive Diagnosis and Treatment", signalling that Zhongnan Hospital of Wuhan University has entered a new stage of development in minimally invasive diagnosis and treatment of hepatobiliary and pancreatic diseases.
Link to the paper: http://link.springer.com/article/10.1007/s00464-021-08404-2
Rewritten by: Lin Wanping
Edited by: Geng Jinwei
