To summarize the application of indocyanine green (ICG) in localization of tumor and determination of resection boundary in robotic resection of liver focal nodular hyperplasia (FNH).

The clinical and pathological data of patients who underwent robotic resection of liver FNH from May 2018 to Oct. 2020 were retrospectively analyzed. According to the tumor size, the patients were divided into < 5 cm and ≥ 5 cm groups. Two days before the operation, ICG was injected through the median elbow vein in all the patients at a dose of 0.25 mg/kg. The position and boundary of FNH in the liver was located by the fluorescence mode of da Vinci Si robotic surgery system and combined with intraoperative ultrasound examination when necessary.

There were 36 patients in this study, including 17 males and 19 females, with an average age of 28.7 years. 35 patients completed robotic tumor resection, and 1 patient was converted to open surgery. The average diameter of tumor was (5.9 ± 4.4) cm, 13 cases were less than 5 cm, 23 cases were more than 5 cm. The median operation time of robotic resection group was 120 min, and the median blood loss was 50 ml, and the average postoperative hospital stay was 3.9 days. Compared with ≥ 5 cm group, < 5 cm group had shorter operation time and less bleeding and shorter postoperative hospital stay (P<0.05).

ICG fluorescence imaging can display the FNH tumor boundary in real time, and guide the surgeon to perform radical resection of tumor by robotic surgery system.