V12-06: Utilization of Indocyanine Green Fluorescence Angiography During Intracorporeal Uretero-ileal Anastomosis Following Robotic Radical Cystectomy
Indocyanine-green (ICG) is an exogenous tracer approved by he FDA and is currently used in several urological procedures such as partial nephrectomies to reveal vascular anatomy and tissue perfusion.
In this video we report our initial experience and proof-of-concept in 10 patients who underwent robotic-assisted radical cystectomy with intracorporeal diversion where ICG was utilized prior to perform uretero-ileal anastomosis to assess ureteric vascularity. _x000D_ _x000D_ _x000D_
In our cohort of 10 patients, 7 patients required resection of distal ureter in at least one ureter. Three patients required bilateral distal ureteral resection, three patients required left and one patient required right distal ureter resection._x000D_ The median resected ureteral lenght was 2cm. The median operation time 510 minutes. Complications were found in 3 patients, fever in two and ileus in one (Clavien II). The median length of stay was 5.5 days and the median follow-up was 81 days._x000D_
Intravenous injection of ICG before ureteroileal anastomosis is useful to evaluate distal ureteral vascularity. It helps to identify and excise the non-vascularized ureteral segment. Long term follow-up will be necessary to evaluate the benefits of ICG-use to prevent ureteroileal strictures.