Introduction : Recently, intraoperative fluorescence imaging using indocyanine green (ICG) has widely been used to open or laparoscopic HPB surgery, for real-time visualization of biological structures and assessment of blood perfusion. Identification of hepatic tumors IV injected ICG accumulated in the cholangiocarcinoma or hepatocellular carcinoma, hepatic segmentation by intraoperative injection of ICG and fluorescence cholangiography excreted into the biliary tract that was injection for identification of hepatic segmentation.

Methods : Sixty eight-years old male patient who have 3.5cm sized hepatic tumor located in the hepatic segment 4 underwent laparoscopic left hepatectomy. Of note, a small 7mm sized satellite tumor located in the segment 8 that was detected in the ICG fluorescent image during laparoscopic exploration, which was not detectable by intraoperative ultrasonography. The satellite nodule was removed by laparoscopy simultaneously.

Results : We herein demonstrate four kinds of application of ICG-fluorescence imaging, detection of tumor, hepatic segmentation, fluorescent cholangiography in a time with video and assessment of hepatic blood perfusion arterial followed by portal.

Conclusions : Application of intraoperative fluorescence imaging in laparoscopic hepatectomy for the HCC is very useful technology to detect the cancer, guide for anatomical resection and identify the bile duct