Future applications of fusion-fluorescence imaging during laparoscopic procedures

Image-guided surgery in hepatobiliary surgery using near-infrared fluorescence (NIRF) is a relatively novel imaging technique that can aid in real-time demarcation of tumors, liver mapping and cholangiography (1). NIRF imaging, using indocyanine green (ICG), can be especially valuable during hepatic minimally invasive procedures, because surgeons are deprived of tactile feedback. This technique proved to be feasible for detection and resection of hepatocellular carcinoma (HCC) as well as metastases, all with different fluorescence patterns (2). The feasibility of fusion-fluorescence imaging using ICG during laparoscopic hepatectomy for identification of hepatic tumors and segmental boundaries was described in Surgical Endoscopy by Terasawa et al. (3).