DOI: https://doi.org/10.36347/sjmcr.2026.v14i04.049

Pages: 796-799

Accurate identification of the intersegmental plane (ISP) is essential in pulmonary segmentectomy to ensure oncological adequacy while preserving lung function. Indocyanine green (ICG) fluorescence imaging has been increasingly used for this purpose; however, conventional bolus injection provides only transient visualization. Constant-rate intravenous infusion offers brighter and more sustained visualization, potentially improving surgical precision. A 66-year-old man with hypertension, dyslipidaemia, and a history of rectal adenocarcinoma was found to have a suspicious pulmonary nodule in the superior segment of the left lower lobe on a surveillance computed tomography (CT) scan. Despite a negative biopsy, surgical resection was performed. The patient underwent video-assisted thoracoscopic superior segmentectomy guided by constant-rate intravenous ICG infusion (12.5 mg/min). Near-infrared imaging demonstrated clear fluorescence of the perfused lung, with the target segment remaining non-fluorescent, enabling precise ISP delineation. The segment was successfully resected, and the patient had an uneventful recovery. Histopathology confirmed primary lung adenocarcinoma with clear margins. Constant-rate intravenous ICG infusion provides stable and enhanced visualization of the ISP compared to conventional bolus injection. This technique is feasible, safe, and may improve surgical precision in minimally invasive segmentectomy. Further studies are required to standardise protocols and evaluate long-term outcomes.