Intraureteral indocyanine green augments ureteral identification and avoidance during complex robotic-assisted colorectal surgery.
colorectal surgery
iatrogenic ureteral injury
intraureteral indocyanine green
lighted ureteral stent
robotic-assisted colorectal surgery
ureteral avoidance
ureteral identification
ureteral stent
Journal
Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland
ISSN: 1463-1318
Titre abrégé: Colorectal Dis
Pays: England
ID NLM: 100883611
Informations de publication
Date de publication:
Mar 2021
Mar 2021
Historique:
revised:
25
08
2020
received:
06
05
2020
accepted:
03
10
2020
pubmed:
17
10
2020
medline:
19
8
2021
entrez:
16
10
2020
Statut:
ppublish
Résumé
Up to 10% of patients who undergo nonurological abdominopelvic operations suffer a ureteral injury. While preoperative ureteral stenting to facilitate identification of the ureter is common, it does not reduce the incidence of intraoperative ureteral injury and is not without risk. As we continue to broaden the application of minimally invasive surgical techniques, a new form of ureteral identification and avoidance that does not rely on tactile feedback is needed. We report our initial experience with intraureteral indocyanine green (ICG) for ureteral identification and avoidance during complex robotic-assisted colorectal surgery. Patients undergoing adjunctive ureteral identification during robotic-assisted colorectal surgery were prospectively identified. Each patient underwent intraureteral ICG administration using rigid cystoscopy (22 Fr). A 5-Fr open-ended ureteral catheter was inserted up to 20 cm and used to inject 5 ml of 2.5 mg/ml ICG as the catheter was withdrawn to the ureteral orifice. Intraureteral ICG was then detected using near-infrared laser fluorescence technology (Firefly®). Successful ICG-enhanced ureteral identification and avoidance was performed in 15 of 16 (94%) patients undergoing robotic-assisted colorectal surgery. The median ICG instillation time was 11.5 min (range 4-21 min) and the median operative time with ICG visualization was 489 min (8 h 9 min) [range 268-738 min (4 h 28 min-12 h 18 min)]. No patient experienced intraoperative ureteral injury and there were no adverse sequelae or complications associated with intraureteral ICG administration. Intraureteral ICG is a safe and effective method of intraoperative ureteral identification and avoidance during complex robotic-assisted colorectal surgery. Precise and prolonged ureteral visualization was achieved, allowing for long operative times compatible with complex robotic-assisted operations.
Substances chimiques
Coloring Agents
0
Indocyanine Green
IX6J1063HV
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
718-723Informations de copyright
© 2020 The Association of Coloproctology of Great Britain and Ireland.
Références
Halabi WJ, Jafari MD, Nguyen VQ, Carmichael JC, Mills S, Pigazzi A, et al. Ureteral injuries in colorectal surgery: an analysis of trends, outcomes, and risk factors over a 10-year period in the United States. Dis Colon Rectum. 2014;57(2):179-86.
Delacroix SE Jr, Winters JC. Urinary tract injures: recognition and management. Clin Colon Rectal Surg. 2010;23(2):104-12.
Parpala-Sparman T, Paananen I, Santala M, Ohtonen P, Hellstrom P. Increasing numbers of ureteric injuries after the introduction of laparoscopic surgery. Scand J Urol Nephrol. 2008;42(5):422-7.
Elliott SP, McAninch JW. Ureteral injuries: external and iatrogenic. Urol Clin North Am. 2006;33(1): 55-66.
Palaniappa NC, Telem DA, Ranasinghe NE, Divino CM. Incidence of iatrogenic ureteral injury after laparoscopic colectomy. Arch Surg. 2012;147(3):267-71.
Aghaji AE, Odoemene C. Ureteric injuries in Enugu, Nigeria. East Afr Med J. 1999;76(4):184-8.
Yang Y, Wang F, Zhang P, Shi C, Zou Y, Qin H et al. Robot-assisted versus conventional laparoscopic surgery for colorectal disease, focusing on rectal cancer: a meta-analysis. Ann Surg Oncol. 2012;19(12):3727-36.
Juo YY, Hyder O, Haider AH, Camp M, Lidor A, Ahuja N. Is minimally invasive colon resection better than traditional approaches?: First comprehensive national examination with propensity score matching. JAMA Surg. 2014;149(2):177-84.
Lim MC, Lee BY, Lee DO, Joung JY, Kang S, Seo SS, et al. Lower urinary tract injuries diagnosed after hysterectomy: seven-year experience at a cancer hospital. J Obstet Gynaecol Res. 2010;36(2):318-25.
Assimos DG, Patterson LC, Taylor CL. Changing incidence and etiology of iatrogenic ureteral injuries. J Urol. 1994;152(6 Pt 2):2240-6.
Chiu AS, Jean RA, Gorecka J, Davis KA, Pei KY. Trends of ureteral stent usage in surgery for diverticulitis. J Surg Res. 2018;222:203-11.
Croghan SM, Zaborowski A, Mohan HM, Mulvin D, McGuire BB, Murphy M, et al. The sentinel stent? A systematic review of the role of prophylactic ureteric stenting prior to colorectal resections. Int J Colorectal Dis. 2019;34(7):1161-78.
Merola J, Arnold B, Luks V, Ibarra C, Resio B, Davis KA et al. Prophylactic ureteral stent placement vs no ureteral stent placement during open colectomy. JAMA Surg. 2018;153(1):87-90.
Hassinger TE, Mehaffey JH, Mullen MG, Michaels AD, Elwood NR, Levi ST, et al. Ureteral stents increase risk of postoperative acute kidney injury following colorectal surgery. Surg Endosc. 2018;32(7):3342-8.
Pathak RA, Taylor AS, Alford S, Broderick GA, Igel TC, Petrou SP, et al. Urologic-induced complications of prophylactic ureteral localization stent placement for colorectal surgery cases. J Laparoendosc Adv Surg Tech A. 2015;25(12):966-70.
Douissard J, Ris F, Morel P, Buchs NC. Current strategies to prevent iatrogenic ureteral injury during colorectal surgery. Surg Technol Int. 2018;32:119-24.
Siddighi S, Yune JJ, Hardesty J. Indocyanine green for intraoperative localization of ureter. Am J Obstet Gynecol. 2014;211(4):436.
Mandovra P, Kalikar V, Patankar RV. Real-Time Visualization Of Ureters Using Indocyanine Green During Laparoscopic Surgeries: Can We Make Surgery Safer? Surg Innov. 2019;26(4):464-8.
Kanabur P, Chai C, Taylor J. Use of indocyanine green for intraoperative ureteral identification in nonurologic surgery. JAMA Surg. 2020;155(6):520.
Lee Z, Moore B, Giusto L, Eun DD. Use of indocyanine green during robot-assisted ureteral reconstructions. Eur Urol. 2015;67(2):291-8.
Chahin F, Dwivedi AJ, Paramesh A, Chau W, Agrawal S, Chahin C, et al. The implications of lighted ureteral stenting in laparoscopic colectomy. JSLS. 2002;6(1):49-52.
Boyan WP Jr, Lavy D, Dinallo A, Otero J, Roding A, Hanos D, et al. Lighted ureteral stents in laparoscopic colorectal surgery; a five-year experience. Ann Transl Med. 2017;5(3):44.
Redan JA, McCarus SD. Protect the ureters. JSLS. 2009;13(2):139-41.