Background : ICG has widely been used in clinical settings mainly for estimation of hepatic function for more than 50 years. ICG is cleared via the biliary system and hence can be useful for identifying tumors involving the liver. These characteristic features of ICG uptake are important in distinguishing potentially malignant or metastatic tumors of disease from other benign lesions.

Methods : We have used the ICG fluorescence imaging technique in six cases of laparoscopic, two cases of open liver resection and four cases of laparoscopic cholecystectomy. A real time images was received by near-infrared light camera system of high-definition optic equipped with a visible infrared light source by Karl Storz system.

Results : ICG fluorescence imaging is a feasible procedure as a tool for intraoperative real-time navigation, excellence of ICG fluorescence provides visualization of demarcation lines and identification of the boundaries of cone units, hepatic segments, and sections. ICG is an anionic molecule that is soluble in water, with a molecular mass of 776 Daltons. After IV injection, ICG binds rapidly to plasma proteins, especially to lipoproteins (albumin). Under near-infrared light, the released fluorescence can be detected using a specifically designed camera.14 Not every laparoscopic equipment includes or is compatible with the usage of an infrared light source, nor does all equipment have the same technology for doing that.

Conclusions : The imaging of fluorescence emitted by ICG is a simple, fast, and relatively inexpensive tool without side effects that has numerous different applications in surgery not only for treating cancers affecting the visceral and hepatobiliary systems but also for visualizing the biliary tree during difficult cholecystectomies. The ability to visualize the vascular structures or the bile duct anatomy allows us to approach laparoscopic techniques of different complexities with greater safety for the patient.