The research progress on the application of ICG fluorescence imaging in robotic D2 lymphadenectomy for gastric cancer: a narrative review.

Gastric cancer is the fifth most common malignant tumor worldwide. Adequate and systematic lymph node dissection not only aids in the accurate staging of gastric cancer but has also been shown to significantly improve the long-term prognosis of patients. In recent years, the use of the da Vinci Surgical System has become increasingly popular in radical gastrectomy for gastric cancer due to its high-definition three-dimensional vision, flexible robotic arm system, and advantages in fine dissection. However, due to the complex anatomy and rich blood supply of the stomach, achieving a thorough D2 lymph node dissection while ensuring surgical safety remains a technical challenge and research hotspot in robotic gastrectomy for gastric cancer. Indocyanine Green (ICG) is a fluorescent tracer dye approved by the U.S. Food and Drug Administration (FDA) for in vivo use. In recent years, ICG has seen increased application in gastrointestinal surgery due to its excellent tissue penetration and lymph node visualization capabilities. However, clinical research on the application of ICG in robotic-assisted radical gastrectomy for gastric cancer, particularly in D2 lymph node dissection, is still limited. The safety, effectiveness, and standardized operating procedures have yet to reach a consensus. Therefore, this review summarizes the research progress on the use of ICG fluorescence imaging in D2 lymph node dissection during da Vinci robotic radical gastrectomy for gastric cancer, aiming to provide references for clinical practice.