Near Infrared Imaging with Indocyanine Green for Resection of Diaphragmatic Endometriosis

Abstract

Study Objective To describe the key principles of successful extra pelvic endometriosis excision, highlighting diaphragmatic endometriosis, and the potential role of indocyanine green and near infrared imaging. Design Case Report. Setting Multidisciplinary surgical case at an academic institution using robotic and near infrared technology. Patients or Participants Thirty-three-year-old para zero with chronic pelvic pain and laparoscopically proven stage IV endometriosis, new onset right shoulder pain and known diaphragmatic disease. Interventions Preoperative MRI followed by robotic-assisted laparoscopic diaphragmatic endometriosis excision using near infrared technology. Measurements and Main Results Complete excision of endometriosis was achieved with resolution of patient's pain. Conclusion Successful diaphragmatic endometriosis excision requires appropriate pre-operative imaging, coordination of a multidisciplinary team, and can be aided by the use of indocyanine green and near infrared imaging. To describe the key principles of successful extra pelvic endometriosis excision, highlighting diaphragmatic endometriosis, and the potential role of indocyanine green and near infrared imaging. Case Report. Multidisciplinary surgical case at an academic institution using robotic and near infrared technology. Thirty-three-year-old para zero with chronic pelvic pain and laparoscopically proven stage IV endometriosis, new onset right shoulder pain and known diaphragmatic disease. Preoperative MRI followed by robotic-assisted laparoscopic diaphragmatic endometriosis excision using near infrared technology. Complete excision of endometriosis was achieved with resolution of patient's pain. Successful diaphragmatic endometriosis excision requires appropriate pre-operative imaging, coordination of a multidisciplinary team, and can be aided by the use of indocyanine green and near infrared imaging.