ICG-Enhanced Fluorescence-Guided Thoracoscopic Surgery for Intrapulmonary Sequestration

Yoshio Tsunezuka, Hideki Fujimori, Nobuhiro Tanaka

Ishikawa Prefectural Central Hospital, Kanazawa, Japan

Date, time and location: 2018.05.26 13:30, Congress Hall, 2F–C

Abstract

:Intrapulmonary sequestration ( ILS) is a relatively rare entity comprising small rate of all congenital pulmonary malformations. ILS is characterized by the presence of nonfunctional parenchymal lung tissue, receiving systemic arterial blood supply. Most of the ILSs are located in the medial and posterior basal segments of the left lung,usually lower lobectomy or basal segmentectomy is performed for non functional lung tissues because of the  rare relationships with lung cancer. However, ILS is not fundamentally malignant disease. The extent of resection must be aimed at preserving as much normal lung tissue as possible , especially in adult with low respiratory function. We reoport the first case operated  after identification of  ILS using intraoperativeimaging with the fluorescent dye indocyanine green (ICG) system. The operation was three port thoracoscopic surgery. Under thoracoscopically, anomalous thoracic aortic branch supplying ILS was incised and inferior pulmonary artery was temporary insulated for retrograde blood supply to ILS tissue.  With ICG imaging system (SPIES:Storz Professional Image Enhancement System, the locaion of ILS was intraoperativelly recognized. ICG (0.5 mg/kg) was injected into an arm vein, and the lung was observed using the ICG imaging system through the port site. The ILS was recognized by SPIES clearily,resected thoracoscopically.