V-12. Navigating the Hostile Mediastinum- Role of ICG Fluorescence in Robotic Esophagectomy

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ID: 326224
2026
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Ranked #88 of 453 articles by views in diseases of the esophagus : official journal of the international society for diseases of the esophagus

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Abstract
Abstract Topic Esophageal Cancer: Surgical Treatment of Esophageal Cancer – technique Video Description This video presents a robotic-assisted Esophagectomy on the Da Vinci Xi platform in a 65-year-old male with mid-thoracic esophageal squamous cell carcinoma (cT3N1M0), following neoadjuvant chemoradiotherapy and metallic esophageal stenting. The central challenge was dense post-radiation fibrosis obliterating the tissue plane between the esophagus and the posterior membranous trachea — rendering conventional white-light dissection unsafe. A novel dual-route ICG fluorescence strategy was employed: reconstituted ICG administered via nebuliser mask prior to induction, followed by intraoperative bronchoscopic instillation — simultaneously illuminating both the esophageal wall and tracheal membrane in real time. The video captures a critical moment where fluorescence imaging identified an imminent tracheal injury risk invisible under white light, enabling immediate corrective dissection and averting a potentially catastrophic complication. This submission is unique in describing, for the first time, a dual-route nebulisation technique that repositions ICG not merely as an anatomical guide, but as an active intraoperative safety sentinel — a conceptually and technically novel contribution directly relevant to the growing global burden of post-chemoradiation esophagectomy.
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openalex_W7204005840 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Abhinav Deshpande
Journal diseases of the esophagus : official journal of the international society for diseases of the esophagus
Year 2026
DOI
10.1093/dote/doag077.412
URL
https://doi.org/10.1093/dote/doag077.412
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