Identifying interlobar fissure in a Craig grade 4 fissureless patient by near-infrared thoracoscopy

Traditionally, surgeons can only count on their naked eyes to identify the fissure in patients with incomplete fissures, which often cause surgical approach into the fissural parenchyma and may lead to postoperative prolonged air leak (PAL). We describe a novel technique using near-infrared (NIR) thoracoscopy with indocyanine green (ICG) to identify the fissure accurately and real-timely for the first time in a patient with totally fused oblique fissure (Craig grade 4).