V2-05: Robotic upper urinary tract reconstruction using near infrared fluorescence imaging

Video

Introductions and Objectives
Near infrared fluorescence imaging (NIRF) is a technology with emerging application in urologic surgery as it provides anatomical and functional information in real time. We evaluated our experience in robotic upper urinary tract reconstruction using NIRF imaging and indocyanine green (ICG).

Methods
A retrospective cohort study was performed using a prospectively maintained, institutional review board-approved database. Robotic upper tract reconstruction was characterized as pyeloplasty, ureteral reimplant, ureterolysis, and ureteroureterostomy. Using a high definition recording system and iMovie software with annotative editing and narration, we created a video outlining examples of our procedures. In this video, we review our technique for robotic upper tract reconstruction using NIRF imaging during pyeloplasty for UPJ obstruction, and in a case of uretero-ureterostomy for a ureteral stricture.

Results
Between April, 2011 to October, 2012 we performed 12 robotic pyeloplasties, 13 ureteral reimplants, 7 ureterolyses, and 2 ureteroureterostomies using NIRF imaging.

Conclusions
This video presents our techniques for upper tract robotic reconstruction using intraoperative NIRF imaging and ICG. In our early experience NIRF imaging appears safe and may allow for improved outcomes secondary to the ability to identify well perfused tissue.

Funding: none