Laparoscopic cholecystectomy using the PINPOINT endoscopic fluorescence imaging system with intraoperative fluorescent imaging: A case report

• The PINPOINT system is safely and effectively at laparoscopic cholecystectomy.
• By intravenously injecting ICG visualizing with the bright field/color fluorescence using the laparoscope PINPOINT system, the cystic duct and common bile duct can be clearly imaged, making this technique advantageous for preventing bile duct injury.
• The ICG fluorescence of the liver is faint, the boundary between the gallbladder and liver can be easily identified.

We report on a laparoscopic cholecystectomy performed using the PINPOINT endoscopic fluorescence imaging system (Novadaq, Mississauga, ON, Canada), which enables surgery to be performed while simultaneously viewing fluorescent images. The patient was a 43-year-old man diagnosed with cholecystolithiasis. Indocyanine green (ICG) was administered 18 h prior to surgery. The PINPOINT system made it possible to perform the procedure while viewing ICG fluorescence in the cystic duct. As the gallbladder was also imaged with this technique, it was easy to determine at which layer to detach the gallbladder from the liver bed. The operative time was 1 h and 32 min, and blood loss was 5 ml. There were no perioperative complications.