Indocyanine green fluorescence-guided pulmonary wedge resection in a child: a case report

Intra-operative photo showing the segment of lung stained by methylene blue under normal light (a); the same segmentof lung seen with indocyanine green fluorescence (b); the wedge of excised lung under normal light (c), and with indocyaninegreen fluorescence (d), confirming complete resection Discussion Intra-operative localisation of small pulmonary nodules remains a challenge for prompt and complete resection of lesions. The United States Food and Drug Administration has recently extended the approved uses of ICG to include sentinel lymph node biopsy in various types of tumour, assessment of blood supply in anastomosis and reconstructive flaps and enhanced visualisation of biliary anatomy during laparoscopic cholecystectomy.4 In thoracic surgery, it is a useful aid to sentinel lymph node mapping, lung mapping, oesophageal conduit vascular perfusion, and lung nodule identification.5 To date, no data about the use of ICG in thoracoscopic wedge resection in paediatric patients have been reported. [...]ICG fluorescence is a safe and feasible method of localisation prior to thoracoscopic wedge resection of a pulmonary nodule in children.