Robotic segmentectomy S7 + S8 with the use of indocyanine green (ICG): technical details

In the last few years, segmentectomy has become a popular alternative procedure with curative intent to standard lobectomy in selected cases, like peripheral ground glass opacities (GGOs) less than 2 cm or patients non suitable for lobectomy. In the setting of a minimally invasive surgery, use of the robotic system Da Vinci has proved to be a safe and feasible approach with better dexterity and lower length of stay compared to video-assisted thoracic surgery (VATS). Moreover, intravenous administration of indocyanine green (ICG) during surgery dramatically improve identification of targeted segment(s) thus sparing a certain amount of healthy lung with better conservation of respiratory function. We hereby show a step-by-step guide to perform a robotic-assisted segmentectomy of right S7 + S8 with the use of ICG for intersegmental plane identification.