We describe our initial positive experience with ICG fluorescence in LA, with a detailed description of dye administration in our study. The technology offers real-time differentiation of tissues and identification of vascular structures, providing immediate guidance during surgery. Further evaluation of its role in adrenocortical malignancy is warranted. NIR fluorescence is a safe, useful addition in laparoscopic adrenalectomy which will undergo further refinement over time.

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HighlightsCombined laparoscopy and thoracospy to be used in tension gastrothorax.Minimally invasive approach to be used even in an emergency.Invasive pre-operative decompression to be avoided.