Indocyanine green nebulization visualizes the pulmonary bronchus during video-assisted thoracoscopic surgery
Abstract Background Intraoperative tracheobronchial injury is a rare but serious complication of lung surgery. With the increasing number of segmentectomies, surgeons need to locate finer and less easily identified segmental bronchi or even subsegmental bronchi. However, there is no simple or feasib...
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| Format: | Article |
| Language: | English |
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BMC
2025-02-01
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| Series: | Journal of Cardiothoracic Surgery |
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| Online Access: | https://doi.org/10.1186/s13019-024-03130-x |
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| author | Hao Xu Xun Wu Songjing Zhao Zhenfan Wang Guanchao Jiang Yun Li Jian Zhou |
| author_facet | Hao Xu Xun Wu Songjing Zhao Zhenfan Wang Guanchao Jiang Yun Li Jian Zhou |
| author_sort | Hao Xu |
| collection | DOAJ |
| description | Abstract Background Intraoperative tracheobronchial injury is a rare but serious complication of lung surgery. With the increasing number of segmentectomies, surgeons need to locate finer and less easily identified segmental bronchi or even subsegmental bronchi. However, there is no simple or feasible method for visualizing the bronchus during surgery. Case presentation Herein, we report a case in which indocyanine green (ICG) inhalation was used to visualize the pulmonary bronchus during video-assisted thoracoscopic surgery. The patient was a woman with a GGO located in the anterior segment of the right upper lobe, and thoracoscopic segmentectomy was scheduled. ICG (3.75 mg/ml) was inhaled into the lung on the operative side after single-lung ventilation for 5 min. During surgery, the anterior segmental bronchus was difficult to locate accurately. Under the overlay imaging window of the NIF imaging system, the bronchus was shown in green, indicating the bronchi in contrast to the surrounding lung tissue. We dissected the bronchi with the assistance of fluorescence imaging and were surprised to find that the bifurcation of the anterior and apical bronchi could be clearly identified by navigation via the inhaled ICG and NIF system. Segmentectomy was successfully performed, and no adverse events were recorded. Conclusion This case showed that ICG nebulization is feasible and safe for visualizing the pulmonary bronchus during thoracoscopic surgery. This method has great application potential for reducing intraoperative tracheobronchial injury. |
| format | Article |
| id | doaj-art-d501387192c04d779ca6ecd137b0a3f6 |
| institution | Kabale University |
| issn | 1749-8090 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Cardiothoracic Surgery |
| spelling | doaj-art-d501387192c04d779ca6ecd137b0a3f62025-02-02T12:42:03ZengBMCJournal of Cardiothoracic Surgery1749-80902025-02-012011510.1186/s13019-024-03130-xIndocyanine green nebulization visualizes the pulmonary bronchus during video-assisted thoracoscopic surgeryHao Xu0Xun Wu1Songjing Zhao2Zhenfan Wang3Guanchao Jiang4Yun Li5Jian Zhou6Department of Thoracic Surgery, Peking University People’s HospitalDepartment of Thoracic Surgery, Beijing Aerospace General HospitalPeking University Health Science CenterDepartment of Thoracic Surgery, Peking University People’s HospitalDepartment of Thoracic Surgery, Peking University People’s HospitalDepartment of Thoracic Surgery, Peking University People’s HospitalDepartment of Thoracic Surgery, Peking University People’s HospitalAbstract Background Intraoperative tracheobronchial injury is a rare but serious complication of lung surgery. With the increasing number of segmentectomies, surgeons need to locate finer and less easily identified segmental bronchi or even subsegmental bronchi. However, there is no simple or feasible method for visualizing the bronchus during surgery. Case presentation Herein, we report a case in which indocyanine green (ICG) inhalation was used to visualize the pulmonary bronchus during video-assisted thoracoscopic surgery. The patient was a woman with a GGO located in the anterior segment of the right upper lobe, and thoracoscopic segmentectomy was scheduled. ICG (3.75 mg/ml) was inhaled into the lung on the operative side after single-lung ventilation for 5 min. During surgery, the anterior segmental bronchus was difficult to locate accurately. Under the overlay imaging window of the NIF imaging system, the bronchus was shown in green, indicating the bronchi in contrast to the surrounding lung tissue. We dissected the bronchi with the assistance of fluorescence imaging and were surprised to find that the bifurcation of the anterior and apical bronchi could be clearly identified by navigation via the inhaled ICG and NIF system. Segmentectomy was successfully performed, and no adverse events were recorded. Conclusion This case showed that ICG nebulization is feasible and safe for visualizing the pulmonary bronchus during thoracoscopic surgery. This method has great application potential for reducing intraoperative tracheobronchial injury.https://doi.org/10.1186/s13019-024-03130-xLung cancerThoracoscopic surgeryIndocyanine green nebulizationNear-infrared fluorescencePulmonary bronchus visualizationIntraoperative tracheobronchial injury |
| spellingShingle | Hao Xu Xun Wu Songjing Zhao Zhenfan Wang Guanchao Jiang Yun Li Jian Zhou Indocyanine green nebulization visualizes the pulmonary bronchus during video-assisted thoracoscopic surgery Journal of Cardiothoracic Surgery Lung cancer Thoracoscopic surgery Indocyanine green nebulization Near-infrared fluorescence Pulmonary bronchus visualization Intraoperative tracheobronchial injury |
| title | Indocyanine green nebulization visualizes the pulmonary bronchus during video-assisted thoracoscopic surgery |
| title_full | Indocyanine green nebulization visualizes the pulmonary bronchus during video-assisted thoracoscopic surgery |
| title_fullStr | Indocyanine green nebulization visualizes the pulmonary bronchus during video-assisted thoracoscopic surgery |
| title_full_unstemmed | Indocyanine green nebulization visualizes the pulmonary bronchus during video-assisted thoracoscopic surgery |
| title_short | Indocyanine green nebulization visualizes the pulmonary bronchus during video-assisted thoracoscopic surgery |
| title_sort | indocyanine green nebulization visualizes the pulmonary bronchus during video assisted thoracoscopic surgery |
| topic | Lung cancer Thoracoscopic surgery Indocyanine green nebulization Near-infrared fluorescence Pulmonary bronchus visualization Intraoperative tracheobronchial injury |
| url | https://doi.org/10.1186/s13019-024-03130-x |
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