Zentralbl Chir 2016; 141 - FV21
DOI: 10.1055/s-0036-1587465

Near-Infrared Fluorescence is useful for identification of the intersegmental plane in thoracoscopic lung segmentectomy

B Bédat 1, S Guigard 2, M Licker 3, F Triponez 2, W Karenovics 2
  • 1Cell Isolation and Transplantation Center, Department of Surgery, Geneva University Hospitals and University of Geneva School of Medicine
  • 2Thoracic and Endocrine Surgery Department, University Hospitals of Geneva
  • 3Department of Anesthesiology, University Hospitals of Geneva

Aim: evaluation of fluorescence imaging during lung segmentectomy by Video-Assisted Thoracic Surgery.

Methods: study of VATS segmentectomies assisted by fluorescence imaging (PINPOINT® Novadaq, Canada) in the University Hospitals of Geneva from November 2014 to August 2015. Analysis of technical input, pathological findings, postoperative course and cTNM/pTNM correlation.

Results: intersegmental plane indentification was perfect in all 17 consecutive segmentectomies, providing additional assistance in case of difficulty with anatomical vascular segmentation. One patient was converted to lobectomy by thoracotomy because of oncological reasons. The postoperative course was uneventful except in 1 patient who developped pneumonia and prolonged air leak (10 days). The drain was removed on POD1 or POD2 in 16 patients with a mean hospital stay of 4.9 +/- 2.3 days. Resections were complete for 4 benign lesions and 13 lung cancers.

Conclusion: fluorescence imaging provides a technical assistance for intersegmental plane identification in VATS, and facilitates vascular identification. It contributes to the quality of diagnostic and therapeutic excisions of small nodules which are often not visible and not palpable during VATS.