WOFAPS 2025 8th World Congress of Pediatric Surgery

Hu Xianchen, Qiu Zhixin, Lin Junshan

The First Affiliated Hospital of Fujian Medical University

Objective

To investigate the efficacy and safety of fluorescence navigation combined with 3D modeling-assisted laparoscopic surgery in the treatment of pediatric focal nodular hyperplasia (FNH) of the liver.

Methods

A retrospective analysis was conducted on children with FNH of the liver who underwent laparoscopic resection assisted by fluorescence navigation and 3D modeling from June 2023 to August 2024. All patients underwent preoperative ultrasound, CT, and MRI imaging for diagnosis and were further evaluated by the software “3D Slicer”for surgical modeling. Intraoperatively, all patients underwent laparoscopic hepatic lesion resection assisted by indocyanine green (ICG). Postoperative complications and recovery indicators were observed.

Results

All patients successfully underwent surgery and were discharged with recovery. No intraoperative complications such as massive hemorrhage or injury of bile duct were observed. The average operative time was (168.3±9.5) minutes, and average hemorrhage in operation was (115.0±20.0) ml. The average postoperative hospital stay was (10.6±1.3) days. In one patient with preoperative imaging highly suggestive of hepatoblastoma, 3D modeling revealed clear lesion margins without vascular invasion. ICG fluorescence enabled precise intraoperative identification and complete resection; postoperative pathology confirmed FNH. In another case with a congenital portosystemic shunt, preoperative modeling delineated aberrant venous anatomy, allowing intraoperative avoidance of major bleeding; no postoperative portal hypertension was observed. One patient with a giant FNH (diameter 5.8 cm) presented with unclear lesion margins on imaging; combined 3D modeling and ICG fluorescence clearly delineated tumor boundaries, facilitating complete resection and uneventful recovery. During a 3-month follow-up, all patients showed normal liver function with no residual lesions, recurrence, or long-term complications such as intrahepatic cholestasis or poor wound healing.

Conclusion

Fluorescence navigation combined with 3D modeling significantly enhances the precision and safety of laparoscopic treatment for pediatric FNH, demonstrating promising clinical value, particularly in complex cases.