ICG‐NIR‐guided lymph node dissection during robotic subtotal gastrectomy for gastric cancer. A single‐centre experience

Background Near‐infrared (NIR) fluorescence imaging with indocyanine green (ICG) allows intraoperative visualisation of the lymph nodes (LNs) draining the tumour. Methods We included in our study 20 patients who underwent robotic subtotal gastrectomy + D2 lymphadenectomy for gastric cancer. In 10 cases, intraoperative ICG‐guided lymphography has been used (Group A). We compared the number of LNs retrieved with the use of NIR imaging and the number of LNs retrieved without the use of this technique (Group B, historical group). Results No complications related to ICG injection or near‐infrared imaging were observed. The mean number of overall LNs retrieved was significantly greater in Group A than in group B (40 vs. 24). No statistically significant difference in operative time was observed. Conclusions ICG‐guided fluorescent lymphography can help in performing a more accurate locoregional lymphadenectomy during robotic subtotal gastrectomy for gastric cancer. This technique represents a precious contribution to gastric cancer surgery.