The safety of minimally invasive anatomical liver resection is a major concern for hepatobiliary surgeons. The Precision Anatomy for Minimally Invasive Hepato-Biliary-Pancreatic Surgery Expert Consensus Meeting was held in 2021. In this meeting, the importance of intraoperative staining of the dominant portal venous region was confirmed, with indocyanine green playing a central role. This article describes the latest findings on minimally invasive laparoscopic anatomical liver resection using the indocyanine green negative staining technique.
Minimally invasive liver resection (MILR) is being widely utilized owing to recent advancements in laparoscopic and robot-assisted surgery. There are two main types of liver resection: anatomical (minimally invasive anatomical liver resection (MIALR)) and nonanatomical. MIALR is defined as a minimally invasive liver resection along the respective portal territory. Optimization of the safety and precision of MIALR is the next challenge for hepatobiliary surgeons, and intraoperative indocyanine green (ICG) staining is considered to be of considerable importance in this field. In this article, we present the latest findings on MIALR and laparoscopic anatomical liver resection using ICG at our hospital.
Intraoperative ICG staining plays a central role in MIALR. MIALR with the Glissonean approach and ICG negative staining, which is our standard technique, is a useful technique using ICG.