Bronchoscopic ICG-guided thoracoscopic segmentectomy for removal of an aspirated dental prosthesis in an elderly patient

An 82-year-old male presented with persistent cough and recurrent pneumonia. Computed tomography revealed a high-density foreign body in the right lower lobe posterior basal segment (S10), later identified as a dental prosthesis. Bronchoscopic removal failed due to severe granulation and impaction. Because of low pulmonary function (FEV1: 920 ml), a lung-preserving procedure was selected. We performed thoracoscopic segmentectomy of S10, guided by bronchoscopic injection of indocyanine green (ICG) into B10a and B10b+c. Intraoperative near-infrared imaging clearly delineated the intersegmental plane. The foreign body was successfully removed, and the patient was discharged on postoperative day 7 without complications. This is the first reported case of bronchial ICG-guided anatomical segmentectomy for foreign body removal in an elderly patient. The technique allowed accurate resection with maximal preservation of lung function, demonstrating its clinical utility beyond oncologic indications.