Novel Use of Indocyanine Green for Intraoperative, Real-time Localization of Ureteral Stenosis During Robot-assisted Ureteroureterostomy

Ureteral Injury During Colorectal Surgery: Two Case Reports and a Literature Review

“…ICG may be used to highlight the ureter anatomy and can be a valid substitute to methylene blue, which is currently used, if IUI is suspected intraoperatively. In 2013, Lee et al 17) published an analysis of 7 patients undergoing robot-assisted ureteroureterostomy for ureteral stricture. ICG was used to identify the lesion and aid in the repair.…”

“…ICG was used to identify the lesion and aid in the repair. It was concluded that intraureteral injection of ICG and visualization under near-infrared (NIR) fluorescent light aided in ureter delineation and identification of healthy versus diseased tissue 17) . The same technique can be transferred to ureter identification and IUI prevention.…”

Advances in fluorescent-image guided surgery

“…Preclinical studies are currently underway to validate the use of fluorescence in anatrophic nephrolithotomy to identify avascular renal planes, assisting the removal of staghorn calculi (117). Intraureteric injection of ICG was used to identify the ureter and locate ureteral strictures in roboticassisted ureteral construction (118,119). One group used a novel technique of imaging near-infrared fluorescence without an injectable contrast agent during robotic-assisted laporoscopic surgery of the urinary tract (120).…”

Laparoendoscopic Single-Site Ureteroureterostomy with Intraoperative Retrograde Ureteroscopy-Assisted Technique for Benign Proximal and Middle Ureteral Strictures: A Single-Center Experience

“…1 UU is traditionally performed through an open approach. In the past two decades, UU has been increasingly performed through several minimally invasive techniques, including laparoscopic UU, 2 robot-assisted UU, 1,3,4 and laparoendoscopic single-site surgery (LESS) UU, 5 with successful outcome and minimal morbidity. In the laparoscopic setting, however, preservation of a healthy ureter with complete resection of the affected part largely depended on visual cues because of the lack of tactile feedback.…”

“…In the laparoscopic setting, however, preservation of a healthy ureter with complete resection of the affected part largely depended on visual cues because of the lack of tactile feedback. 1 The site and extent of the stricture might not be easily determined from the extraluminal aspect owing to the presence of inflammation, fibrosis, and obliteration of dissection planes. 1,4,6 That poses a technically challenging situation for the urologist, especially through the LESS technique, because failure in identification of the exact position of the stricture can lead to incomplete resection or a shortened ureter.…”