Real-Time Bladder Perfusion Assessment Using ICG Fluorescence Imaging Enables Successful Reconstruction

Area of Science:

• Urology
• Surgical Oncology
• Medical Imaging

Background:

• Recurrent pelvic tumors can compromise bladder and ureteral structures.
• Assessing bladder perfusion is crucial for organ preservation during complex oncologic surgeries.

Purpose of the Study:

• To evaluate the utility of intraoperative indocyanine green (ICG) fluorescence imaging for assessing bladder perfusion.
• To determine if ICG imaging can guide bladder preservation in cases with compromised vascular supply.

Main Methods:

• A case report detailing the use of ICG fluorescence imaging during pelvic tumor resection.
• ICG imaging was employed to assess bladder wall perfusion after sacrifice of bilateral vesical arteries.
• Postoperative evaluation included contrast-enhanced CT and cystoscopy.

Main Results:

• ICG fluorescence imaging demonstrated uniform bladder wall perfusion, supporting bladder preservation.
• Postoperative imaging and cystoscopy confirmed preserved bladder perfusion and mucosal integrity.
• The patient achieved spontaneous voiding without dysfunction.

Conclusions:

• Intraoperative ICG imaging provides real-time assessment of bladder perfusion, facilitating safe bladder preservation.
• This technique is valuable for intraoperative decision-making in complex pelvic surgeries involving potential vascular compromise.