Intra-ureteric indocyanine green for ureteric visualisation in complex benign gynaecological surgery: a prospective
Bomee Kim1, Julia Mazurek1, Rakesh Thing1
1Department of Gynaecology, Princess Royal Hospital, University Hospitals Sussex NHS Foundation Trust, Brighton, United Kingdom.
Abstract:
Ureteric injury is a serious complication of gynaecological surgery, particularly in cases involving deep endometriosis. This prospective cohort study assessed the feasibility and safety of intra-ureteric indocyanine green (ICG) for real-time ureteric visualisation in complex endometriosis surgery at a tertiary referral unit. Fifty consecutive patients undergoing laparoscopic procedures received cystoscopy-guided bilateral intra-ureteric ICG. Mean additional operative time was 160 seconds. Bilateral ureteric fluorescence was achieved in all cases and persisted throughout surgery. Guidewires and intra-operative stents were required in 2% and 4% of cases, respectively. No ICG-related adverse events or ureteric injuries occurred, demonstrating a rapid, safe and reproducible technique.
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