Abstract
Virtual-assisted lung mapping is a bronchoscopic multiple dye marking technique that facilitates sublobar lung resections for unidentifiable pulmonary tumors. Marking failure reportedly occurs in 10% of cases. To overcome this limitation, we developed indocyanine green virtual-assisted lung mapping that uses indocyanine green in addition to indigo carmine. Here, we report our initial experience of indocyanine green virtual-assisted lung mapping.
Highlights
To overcome the limitations of marking failure because of patient conditions, we used indocyanine green (ICG) dye to visualize the markings more effectively
We present our initial experience with ICG Virtual-assisted lung mapping (VAL-MAP)
Once the tip was confirmed to have reached the pleura under X-ray fluoroscopy, ICG and Indigo carmine (IC) were injected into the target bronchus simultaneously by pushing the plunger of the syringe connected to the catheter, followed by 20 ml of air injection for each mark (Fig. 2c, d)
Summary
To overcome the limitations of marking failure because of patient conditions, we used indocyanine green (ICG) dye to visualize the markings more effectively. ICG fluorescence was visualized with a near-infrared thoracoscope. We developed this novel procedure (ICG VAL-MAP) using ICG and IC. We present our initial experience with ICG VAL-MAP. Virtual-assisted lung mapping (VAL-MAP) is a preoperative bronchoscopic multi-spot dye marking technique that uses virtual bronchoscopic navigation to localize unidentifiable pulmonary nodules during subsequent surgery [1, 2]. VAL-MAP is an important technique for thoracic surgeons to achieve sublobar lung resections. Indigo carmine (IC), a dye used conventionally in VAL-MAP, fades and might be inappropriate for these conditions [3]
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