Tracer-Guided Stomach Cancer Residual Lymph Node Dissection

Radical lymphadenectomy can improve tumor staging accuracy and long-term survival of patients with gastric cancer. The procedure is typically performed by eye and depends on a surgeon’s experience. Indocyanine green (ICG) near-infrared (NIR) fluorescent imaging has improved sentinel lymph node localization in other cancers and has been incorporated into laparoscopic device technology. This procedure video illustrates ICG tracer-guided complementary dissection of residual lymph node-bearing soft tissue after laparoscopic radical gastrectomy and general lymph node dissection in a patient with gastric cancer. Click https://ja.ma/2VlYnRr for a video illustrating the preoperative injection of ICG tracer, https://ja.ma/2w2tXJu for a video of the general lymph node dissection procedure, https://ja.ma/2I0Glw9 for a video of in vitro lymph node retrieval under direct NIR imaging, and https://ja.ma/2vfIAsU for a complete discussion of the procedure and the findings from a trial comparing it with non-ICG tracer-guided lymph node dissection.