Near-Infrared Fluorescence Imaging with Intraoperative Administration of Indocyanine Green for Robotic Partial Nephrectomy
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Near-infrared fluorescence (NIRF) imaging with intraoperative administration of indocyanine green (ICG) is a technology with emerging applications in urologic surgery. ICG is a water-soluble dye that fluoresces bright green when viewed under near-infrared light (700–1000 nm). This technology has been applied to robotic partial nephrectomy, first to potentially allow for the differentiation of renal tumor from normal parenchyma. In this application, it has been hypothesized that normal kidney tissue fluoresces green, while the tumor commonly remains hypofluorescent, thereby aiding tumor excision. Secondly, NIRF imaging with ICG has been employed to facilitate selective arterial clamping during robotic partial nephrectomy, allowing for a regional perfusion deficit in the kidney to be readily identified and therefore targeted at a given tumor. Recent studies have shown the associated decrease in global ischemia to minimize resultant loss of renal function at certain time endpoints. This review presents the most recent studies and evidence on the intraoperative administration of indocyanine green for robotic partial nephrectomy.
KeywordsNear-infrared fluorescence imaging Indocyanine green Robotic partial nephrectomy Selective arterial clamping Tumor localization
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Conflict of Interest
Dr. Marc A. Bjurlin and Dr. Tyler R. McClintock each declare no potential conflicts of interest.
Dr. Michael D. Stifelman is a consultant for Vascular Technology Inc. and Surgiquest and a lecturer/ownership of Intuitive Surgical, Inc.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
MDS: Consultant VTI, Consultant Surgiquest, Lecturer/Ownership Intuitive Surgical, Inc.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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