A Case of Rectal Cancer with Vaginal Invasion Using Indocyanine Green to Determine the Extent of Resection.

Here we report a case of locally advanced rectal cancer with vaginal invasion, which was successfully resected via laparoscopic surgery using intraoperative indocyanine green (ICG) navigation to determine the vaginal cut line. Based on preoperative examinations, an 81-year-old female was diagnosed with locally advanced rectal cancer with vaginal invasion. After preoperative chemoradiotherapy, the lesion was judged to be resectable. During surgery, the gynecologist transvaginally injected ICG into the vaginal submucosa to determine the caudal margin of the vaginal invasion, and laparoscopically dissected under the near-infrared image of the stained area. Pathological analysis of the resection specimen revealed negative resection margins. One year after surgery, there has been no recurrence.