Robotic Right Upper Lobe Posterior Segmentectomy With ICG Guidance

This video demonstrates a robotic right upper lobe segmentectomy using indocyanine green (ICG) guidance. The patient was a 73-year-old woman who had a previous left lower lobectomy for squamous cell cancer and removal of a malignant station L8 lymph node. She presented with a new nodule in the posterior segment of her right upper lobe, which was thought to be a new primary cancer. Segmentectomy was therefore the procedure of choice in order to conserve as much pulmonary function as possible.

ICG was used in order to aid and confirm decision making when a posterior ascending artery with an early bifurcation was encountered, helping to determine whether both of the branches provided vascularization to the posterior segment in question.