Background : Indocyanine green (ICG) fluorescence image-guided in laparoscopic hepatic resection is a surgical method with advantages in tumor localization, anatomical resection through an accurate demarcation line, and bile duct resection for safe remnant duct. However, the efficacy and safety of this surgical method are still controversial.

Methods : As a single center and young liver surgeon, I would like to introduce video cases of laparoscopic hepatectomy using the ICG system.

Results : First, a Comparison of 2 cases of mono-segmentectomy (S5, anatomical resection by ICG) for treatment of Segment 5 hepatocellular carcinoma (HCC) and 1 case of S5/8 wedge resection for treatment of S5/8 HCC. Next, as a major hepatectomy, 2 cases of Lt. hemihepatectomy (individual, glissonean approach). Finally, I would like to show Extended Rt. hemihepatectomy for multiple HCC of Rt. Lobe.

Conclusions : Using the ICG system and Intraoperative ultrasound (IOUS), accurate anatomical resection and appropriate tumor margins are secured to enable relatively safe and precise surgery. Applying it to hepatectomy under challenging cases results in acceptable outcomes.