V09-01 LAPAROSCOPIC INTRAOPERATIVE BLUE LIGHT VISUALIZATION OF THE URETERS UTILIZING THE NOVEL FLUORESCENT TRACER AGENT MB-102 – AN IN VIVO PORCINE STUDY

Abstract

You have accessJournal of UrologyUpper Tract Reconstruction (V09)1 Sep 2021V09-01 LAPAROSCOPIC INTRAOPERATIVE BLUE LIGHT VISUALIZATION OF THE URETERS UTILIZING THE NOVEL FLUORESCENT TRACER AGENT MB-102 – AN IN VIVO PORCINE STUDY Joshua Palka, Shilpa Argade, Michael Talcott, Thomas Rogers, Richard Dorshow, and Ramakrishna Venkatesh Joshua PalkaJoshua Palka More articles by this author , Shilpa ArgadeShilpa Argade More articles by this author , Michael TalcottMichael Talcott More articles by this author , Thomas RogersThomas Rogers More articles by this author , Richard DorshowRichard Dorshow More articles by this author , and Ramakrishna VenkateshRamakrishna Venkatesh More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002052.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Abdominal and pelvic laparoscopic and robotic surgical procedures carry a risk of iatrogenic injury to the ureters. Intra-operative identification of ureter or ureteral injury is critical to prevent serious complications. We evaluated MB-102, a novel fluorescent tracer agent constructed to be excreted by the renal system only, and currently in on-going clinical studies for renal function determination. We evaluated MB-102 for locating ureters during laparoscopic surgery. METHODS: We evaluated MB-102 in 2 domestic pigs weighing approximately 30 kg. MB-102 was injected intravenous at 3.2 mg/kg, and using a Karl Storz laparoscopic unit, the ureter was visualized under white & blue light laparoscopy before and after transperitoneal laparoscopic dissection. The ureteral fluorescence from the agent in ureteral lumen was evaluated at different light intensity settings. The plasma kinetics of MB-102 was monitored simultaneously with the appearance and presence of ureteral fluorescence. In the second pig, a 5Fr retrograde catheter was inserted into the ureter under cystoscopic guidance for instillation of MB-102 in a retrograde fashion at different concentrations. A deliberate partial and total transection of ureter and intra-renal collecting system was performed for ease of visualization of extravasated MB-102. RESULTS: The ureter was very well visualized within 5 minutes after intravenous injection of MB-102 under the blue light as a bright yellow-orange tubular fluorescent structure with peristalsis before and after exposing the ureter. This was best visualized at a light setting of 20% intensity. The ureteral fluorescence lasted for more than 45 minutes following intravenous injection. In the second pig, upon retrograde administration of the agent, the ureter illuminated with bright fluorescence under blue light easily at different concentrations. Finally, deliberate transection of the ureter and the intra-renal collected system showed bright fluorescent urine leaking from the injured site akin to a volcanic lava. CONCLUSIONS: The novel fluorescent agent MB-102 facilitated easy & early visualization of the ureter under blue light during laparoscopy. MB-102 with its renal only filtration property and bright fluorescence is potentially a very good agent to identify ureter and ureteral injuries. Source of Funding: MediBeacon © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e687-e687 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Joshua Palka More articles by this author Shilpa Argade More articles by this author Michael Talcott More articles by this author Thomas Rogers More articles by this author Richard Dorshow More articles by this author Ramakrishna Venkatesh More articles by this author Expand All Advertisement Loading ...