Category: Robotic Surgery: New Techniques - Malignant

VS7-10 - Indocyanine Green, capabilities and utilization in partial nephrectomy

Sat, Sep 22
10:00 AM - 12:00 PM

Introduction & Objective :

According to international guidelines, partial nephrectomy should be performed in small renal masses whenever technically feasible. Even for renal tumors larger than 7 cm, partial nephrectomy seems to provide similar oncologic outcomes if compared with radical nephrectomy. There is a trend that complex renal tumors are treated by nephron-sparing surgery. Intraoperative imaging may help perform oncologically safe partial nephrectomy as it can be used for tumor localization and also differentiate tumor from normal kidney parenchyma and assess a surgical cavity and margins of a resected specimen. Up-to-date intraoperative imaging techniques, which can aid in complete RCC resection, are as follows: intraoperative ultrasonography, fluorescence imaging, augmented reality, optical coherence tomography, ex vivo MRI.

Methods :

We present 4 cases of robot-assisted and laparoscopic partial nephrectomy with use of intraoperative fluorescence imaging.

Results :

Advantages of fluorescence imaging during partial nephrectomy include: aid in intraoperative differentiation between tumor and normal tissue (RCCs appear hypofluorescent compared with normal kidney parenchyma); potentially assisting in tumor margin demarcation; facilitating selective arterial clipping by in-vivo visualization of the arterial branches; defining a devascularized area during selective clipping and also defining normal vascularization (absence of ischemic zones) after suturing the tumor bed.

Conclusions :

Fluorescence imaging is simple and safe method that bring a lot of additional information during partial nephrectomy.

Evgeny Bezrukov

Head of the urological department №1
Sechenov University
Moscow, Moskva, Russia

Leonid Rapoport

Deputy Director
RI for Uronephrology, Sechenov University
Moscow, Moskva, Russia

Evgeny Sirota

Moscow, Moskva, Russia

Roman Slusarenco

Moscow, Moskva, Russia

Andrei O. Morozov

Sechenov First Moscow State Medical University
Moscow, Moskva, Russia

Nikita Sushentsev

Moscow, Moskva, Russia