MP10-07 ANGIOGRAPHY OF THE NEUROVASCULAR BUNDLE USING INDOCYANINE GREEN AND NEAR-INFRARED FLUORESCENCE: A SIMPLE, NON-INVASIVE TECHNIQUE FOR NERVE-SPARING PROCEDURES DURING ROBOT-ASSISTED RADICAL PROSTATECTOMY

Abstract

You have accessJournal of UrologySurgical Technology & Simulation: Instrumentation & Technology I (MP10)1 Sep 2021MP10-07 ANGIOGRAPHY OF THE NEUROVASCULAR BUNDLE USING INDOCYANINE GREEN AND NEAR-INFRARED FLUORESCENCE: A SIMPLE, NON-INVASIVE TECHNIQUE FOR NERVE-SPARING PROCEDURES DURING ROBOT-ASSISTED RADICAL PROSTATECTOMY Nordine Amara, Tarek Al Youssef, Jordan massa, Belur Usa Usa, Elias Elkhouri, and Jules Forgeois Nordine AmaraNordine Amara More articles by this author , Tarek Al YoussefTarek Al Youssef More articles by this author , Jordan massaJordan massa More articles by this author , Belur Usa UsaBelur Usa Usa More articles by this author , Elias ElkhouriElias Elkhouri More articles by this author , and Jules ForgeoisJules Forgeois More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001983.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Erectile dysfunction (ED) is a major postoperative complication after radical prostatectomy (RP) with a great impact on the quality of life of the patients. According to current knowledge of the surgical anatomy of the prostate we investigated the value of intraoperative angiography of the neurovascular bundle (NVB) using indocyanine green (ICG) and near-infrared fluorescence during robot-assisted radical prostatectomy (RARP) to improve the preservation of ED. METHODS: From June 2016 to February 2021, 207 patients with localized prostate cancer were treated by RARP. Among this population 91 patients underwent RARP with intra operative angiography using the Da Vinci® Xi system (Intuitive Surgical) and the Firefly® fluorescence imaging system. We evaluated the proportion (%) of NVB identified to optimize and facilitate the dissection, as well as any ICG-related complications that occurred. All patients were followed up at 3, 6, 9, and 12 months after surgery to evaluate their erectile function using the Sexual Health Inventory for Men scores (SHIM Score). RESULTS: NVB were identified in 100% of cases without any difficulties. No ICG-related complications or allergies were observed. Intraoperative, real-time angiography helped us to accurately visualize and perform microdissection of the NVB by alternately using fluorescence and standard light. Postoperative erectile function was significantly improved in patients who underwent this nerve-sparing procedure. CONCLUSIONS: This fluorescence-guided surgery is simple, non-invasive promising technique that reveal deep structures and improve the identification of key anatomical landmarks to optimize NVB micro-preservation. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e170-e171 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Nordine Amara More articles by this author Tarek Al Youssef More articles by this author Jordan massa More articles by this author Belur Usa Usa More articles by this author Elias Elkhouri More articles by this author Jules Forgeois More articles by this author Expand All Advertisement Loading ...