1210 NEAR INFRARED FLUORESCENCE IMAGING FOR THE DA VINCI SI SURGICAL SYSTEM: INITIAL CLINICAL EXPERIENCE WITH ROBOT-ASSISTED LAPAROSCOPIC PARTIAL NEPHRECTOMY FOR RENAL CORTICAL TUMORS

Abstract

You have accessJournal of UrologyTechnology & Instruments: Robotics/Laparoscopy1 Apr 20111210 NEAR INFRARED FLUORESCENCE IMAGING FOR THE DA VINCI SI SURGICAL SYSTEM: INITIAL CLINICAL EXPERIENCE WITH ROBOT-ASSISTED LAPAROSCOPIC PARTIAL NEPHRECTOMY FOR RENAL CORTICAL TUMORS Scott Tobis, Joy Knopf, Christopher Silvers, Jorge Yao, Hani Rashid, Guan Wu, and Dragan Golijanin Scott TobisScott Tobis Rochester, NY More articles by this author , Joy KnopfJoy Knopf Rochester, NY More articles by this author , Christopher SilversChristopher Silvers Rochester, NY More articles by this author , Jorge YaoJorge Yao Rochester, NY More articles by this author , Hani RashidHani Rashid Rochester, NY More articles by this author , Guan WuGuan Wu Rochester, NY More articles by this author , and Dragan GolijaninDragan Golijanin Rochester, NY More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.866AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To evaluate the utility of near infrared fluorescence (NIRF) of intravenously injected indocyanine green (ICG) in performing robot-assisted laparoscopic partial nephrectomy (RALPN). In addition, we evaluated the initial performance of a novel NIRF imaging system integrated into the da Vinci® Si Surgical System during RALPN. METHODS A Fluorescence imaging for the da Vinci Si Surgical System (Intuitive Surgical, Sunnyvale, CA) was utilized for all cases. ICG was injected prior to near infrared imaging. Immediate imaging assessed the renal vasculature, while delayed imaging differentiated renal cortical tumors from normal parenchyma. The intraoperative performance of NIRF of intravenous ICG was evaluated for tumor appearance relative to surrounding renal parenchyma as well as identification of the renal vasculature. RESULTS Eleven patients underwent RALPN, with two converted to robot-assisted laparoscopic radical nephrectomy. ICG injections were repeated up to a total of 5 times depending on the goal of visualization. Ten of the 11 patients demonstrated a malignancy on final pathology. Of the malignant tumors, 7 were hypofluorescent and 3 isofluorescent compared to the surrounding renal parenchyma. NIRF imaging delineated the vascular anatomy in all cases. All surgical margins were negative on final pathology. CONCLUSIONS Intraoperative imaging of ICG with NIRF is a safe and effective method to accurately identify the renal vasculature and to differentiate renal tumors from surrounding normal parenchyma. The capacity for multimodal imaging within the surgical console further facilitates this imaging. Further study is needed to determine if this technique will help improve outcomes from RALPN. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e485-e486 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Scott Tobis Rochester, NY More articles by this author Joy Knopf Rochester, NY More articles by this author Christopher Silvers Rochester, NY More articles by this author Jorge Yao Rochester, NY More articles by this author Hani Rashid Rochester, NY More articles by this author Guan Wu Rochester, NY More articles by this author Dragan Golijanin Rochester, NY More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...