Single-Plane Retroperitoneoscopic Adrenalectomy Guided by Indocyanine Green Dye: An Optimized Step

Area of Science:

• Surgical Oncology
• Minimally Invasive Surgery
• Medical Imaging

Background:

• Adrenalectomy is a common surgical procedure for adrenal tumors.
• Single-plane posterior retroperitoneoscopic adrenalectomy (SPRA) is a minimally invasive approach.
• Accurate localization of the adrenal gland is crucial for successful SPRA.

Purpose of the Study:

• To evaluate the perioperative outcomes of SPRA guided by indocyanine green dye (ICG) fluorescence imaging.
• To compare outcomes between ICG-guided and non-ICG-guided SPRA.
• To assess the impact of ICG fluorescence on adrenal gland localization and surgical efficacy.

Main Methods:

• Retrospective analysis of 23 patients undergoing SPRA.
• Patients divided into ICG-guided (n=12) and non-ICG-guided (n=11) groups.
• Comparison of baseline demographics, operative parameters, and postoperative outcomes.

Main Results:

• The ICG group showed significantly shorter adrenal gland localization time (5.58 vs 7.55 min, p<0.001) and total operative time (27.50 vs 45.00 min, p<0.001).
• Estimated blood loss was significantly reduced in the ICG group (22.91 vs 54.54 mL, p<0.001).
• Lower visual analog pain scores were observed at 24 hours postoperatively and at discharge in the ICG group (p=0.001 and p=0.006, respectively).

Conclusions:

• ICG-guided SPRA is a safe and effective procedure for adrenal tumors.
• ICG fluorescence enhances adrenal gland localization accuracy and surgical efficacy.
• The technique offers significant benefits in perioperative outcomes, including reduced operative time, blood loss, and postoperative pain.