Application of Indocyanine Green in Combination with Da Vinci Xi Robot in Surgeries on the Upper Urinary Tract: A Case Series Study

Author:

Zeng Sheng1,Xing Shaoqiang2,Xing Wenzhou1,Bai Zhijie1,Zhang Jingyuan3,Li Yanan3,Wang Haifeng1,Liu Qian1

Affiliation:

1. Department of Urology, Tianjin First Central Hospital, Tianjin 300192, China

2. The First Clinical Medical College, Tianjin Medical University, Tianjin 300192, China

3. Department of Operating Room, Tianjin First Central Hospital, Tianjin 300192, China

Abstract

Background: To explore the application value of intraoperative imaging by indocyanine green (ICG) injection through the collection system of the urinary tract for Da Vinci Xi robot navigation in complex surgeries on the upper urinary tract. Methods: Data of 14 patients who underwent complex surgeries of the upper urinary tract post-ICG injection through the collection system of the urinary tract in combination with Da Vinci Xi robot navigation in the Tianjin First Central Hospital between December 2019 and October 2021 were analyzed in this retrospective study. The operation duration, estimated blood loss, and exposure time of ureteral stricture to ICG were evaluated. The renal functions and tumor relapse were evaluated after surgery. Results: Of the fourteen patients, three had distal ureteral stricture, five had ureteropelvic junction obstruction, four presented duplicate kidney and ureter, one had a giant ureter, and one presented an ipsilateral native ureteral tumor after renal transplantation. The surgeries in all patients were successful, with no conversion to open surgery. In addition, no injury to the surrounding organs, anastomotic stenosis or leakage, or ICG injection-related side effects were detected. Imaging at 3 months post-operatively revealed improved renal functions compared to those before the operation. No tumor recurrence or metastasis was observed in patient 14. Conclusion: Fluorescence imaging compensating for the inadequacy of tactile feedback in the surgical operating system has advantages in identifying the ureter, determining the site of ureteral stricture, and protecting the blood flow for the ureter.

Funder

National Natural Science Youth Science Foundation Project

Tianjin Natural Science Foundation Youth Program

General Project of Tianjin Natural Science Foundation

Tianjin Health Science and Technology Project

Tianjin Key Medical Discipline (Specialty) Construction Project

Publisher

MDPI AG

Subject

General Medicine

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