Pediatric Focal Nodular Hyperplasia (FNH) presents diagnostic and therapeutic challenges. This study aimed to evaluate the safety and efficacy of a novel integrated approach combining preoperative three-dimensional (3D) modeling with intraoperative indocyanine green (ICG) fluorescence navigation for laparoscopic resection of pediatric FNH.

We retrospectively analyzed a total of 10 pediatric patients with FNH who were included and underwent laparoscopic hepatectomy using this combined technique between June 2023 and August 2024. Preoperative contrast-enhanced CT/MRI data were used to generate patient-specific 3D liver models for surgical planning. Intraoperatively, ICG fluorescence was utilized for real-time lesion demarcation and margin assessment. Perioperative outcomes data were systematically collected and analyzed.

All 10 procedures were successfully completed laparoscopically without conversion. Regarding perioperative safety, no major intraoperative complications occurred. Postoperatively, there were no major complications; minor adverse events were limited to transient, self-limiting elevations of liver enzymes. The mean operative time was 168.3 ± 9.5 min, with a mean estimated blood loss of 115.0 ± 20.0 ml. The mean postoperative hospital stay was 10.6 ± 1.3 days. The 3D models combing with ICG fluorescence can precisely delineated tumor margins, facilitating complete R0 resection in all cases. At 3-month follow-up, all patients exhibited normal liver function with no evidence of residual disease or recurrence.

The integration of 3D virtual modeling and ICG fluorescence navigation is a safe and highly effective strategy for the laparoscopic management of pediatric FNH.