研究目的
To report the first case of ICG fluorescence image-guided total laparoscopic living donor right hepatectomy in Mainland China, demonstrating its feasibility and advantages in enhancing surgical precision and safety.
研究成果
ICG fluorescence image-guided TLDRH is feasible and can enhance precision and safety by real-time visualization of surgical margins and biliary structures, potentially simplifying the procedure and avoiding traditional cholangiography. More practice and technical refinements are needed for broader application.
研究不足
The study is based on a single case, limiting generalizability. Spillover of ICG during injection was noted, requiring technical modifications. The procedure is restricted to highly selected cases with modal liver anatomy and requires experienced surgical teams.
1:Experimental Design and Method Selection:
A case report design was used to describe the surgical procedure. The method involved using ICG fluorescence imaging for real-time visualization during laparoscopic hepatectomy.
2:Sample Selection and Data Sources:
One 34-year-old male living donor was selected based on comprehensive evaluation including MRCP and CT image-based three-dimensional reconstruction.
3:List of Experimental Equipment and Materials:
Equipment included a laparoscopy system with an infrared fluorescence probe (Pinpoint, Stryker), Cavitron Ultrasonic Surgical Aspirator (CUSA), harmonic scalpel, and ICG dye. Materials included trocars, clips, sutures, and cryopreserved iliac artery allografts.
4:Experimental Procedures and Operational Workflow:
The donor underwent total laparoscopic right hepatectomy with ICG injected into the right portal branch for fluorescence mapping. Liver transection was performed tracing the fluorescence borderline, and biliary structures were visualized after intravenous ICG injection. The graft was retrieved through a suprapubic incision.
5:Data Analysis Methods:
Operative time, blood loss, warm ischemia time, and postoperative recovery were monitored and compared to standard procedures.
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