VATS Right Basilar Segmentectomy for Typical Carcinoid and the Use of Indocyanine Green

This video details a thoracic surgical procedure in which a video-assisted thoracoscopic surgery (VATS) right basilar segmentectomy is performed on a patient with a typical carcinoid tumor. The procedure is enhanced by using indocyanine green (ICG), a fluorescent dye inserted intravenously, that improves the visualization of anatomical structures. 

The video begins with a brief overview of the patient's medical history and diagnosis, including imaging studies that show the location and extent of the carcinoid tumor in the right lower lobe. During the surgery, the use of ICG is demonstrated. This technique enables surgeons to clearly delineate the parenchymal demarcation, accurately mark it with cautery, and then divide it while preserving healthy lung tissue. The video captures critical steps of the procedure, including the identification and division of segmental vessels and the use of staple lines for parenchymal division. 

Throughout the video, the surgical team provides commentary and discusses postoperative outcomes, including the patient’s recovery and follow-up care. This case emphasizes the benefits of minimally invasive surgery and the role of ICG in enhancing surgical accuracy and safety. 

This procedure aims to educate thoracic surgeons on the advanced techniques and technologies available for the management of typical carcinoid tumors; showcasing the efficacy of VATS segmentectomy combined with ICG. 

References

1. Matsuura, Y., et al. (2019). "The Use of Indocyanine Green in Thoracic Surgery: A Narrative Review." General Thoracic and Cardiovascular Surgery, 67(1), 132-137. DOI: 10.1007/s11748-018-1008-5.
2. Matsuura, Y., Ichinose, J., Nakao, M. et al. Recent fluorescence imaging technology applications of indocyanine green in general thoracic surgery. Surg Today 50, 1332–1342 (2020). https://doi.org/10.1007/s00595-019-01906-6

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