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Indocyanine green assisted Laparoscopic Partial Nephrectomy

Amol Wagh, MS1, Eham Arora, MS1, Shubham Gupta, MS1, Chintan Patel, MS2, Jasmine Agarwal1, Ajay Bhandarwar, MS1. 1Grant Government Medical College & Sir JJ Group of Hospitals, India, 2Kiran Multi-Super Specialty Hospital & Research Center, Surat, India

Introduction: Indocyanine green is a water soluble nontoxic compound exhibiting near infrared fluorescence at a wavelength of 800 nm.

Partial nephrectomy is a nephron sparing surgery & the surgical treatment of choice for renal mass in:

  • a patient with a solitary kidney
  • compromised contralateral kidney
  • bilateral renal masses
  • small localised renal tumours in patients with a normal contralateral kidney

This surgery helps in secondarily improving renal function and long-term survival.

Indocyanine fluorescence helps in assessing vascular flow, tissue perfusion and aberrant anatomy and thereby leads to lower conversion rates in partial nephrectomy.

We aim to present our experience in 44 patients who underwent partial nephrectomy over 7 years.

Materials and methods: Of the 44 partial nephrectomies performed at our institution, 24 were done by laparoscopic approach alone and rest 20 by Indocyanine green dye administration as an adjunct to laparoscopic approach .

Pinpoint ICG system with 4 effective modes provides real time endoscopic visible and near infrared fluorescence imaging. It combines image on same plane enabling coupling of images and simultaneous dissection without switching to normal white light mode while dissection.

Result:

Conclusion: Indocyanine fluorescence is a safe & feasible adjunct to laparoscopic partial nephrectomy. It helps in selective clamping, achieving “zero ischemia”, helping renal function recover faster post-operatively. Identification of renal vasculature and tumour margins improve the surgeon’s ability & speed to perform this procedure effectively. 


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 87282

Program Number: P830

Presentation Session: iPoster Session (Non CME)

Presentation Type: Poster

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