Exploring the feasibility of indocyanine green fluorescence for intraoperative ureteral visualisation in robotic transvaginal natural orifice transluminal endoscopy surgery during endometriosis resection

IF 2.3 3区医学 Q2 SURGERY

International Journal of Medical Robotics and Computer Assisted Surgery Pub Date : 2024-05-16 DOI:10.1002/rcs.2636

Luis E. Delgadillo Chabolla, Linda A. Alpuing Radilla, Tamisa Koythong, Sowmya Sunkara, Yamely Mendez, Qianqing Wang, Xiaoming Guan

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引用次数: 0

Abstract

Background

To assess the feasibility of use of indocyanine green (ICG) in identifying and minimising urinary tract injury during surgical resection of endometriosis through robotic transvaginal natural orifice transluminal endoscopy surgery (RvNOTES).

Methods

We conducted a retrospective case series in two academic tertiary care hospitals. We examined 53 patients who underwent RvNOTES hysterectomy with planned endometriosis resection.

Results

The study involved 53 patients undergoing RvNOTES with ICG fluorescence for endometriosis resection. Mean patient age was 37.98 ± 6.65 years. Operative time averaged 181.32 ± 53.94 min, with estimated blood loss at 45.57 ± 33.62 mL. Postoperative stay averaged 0.23 ± 0.47 days. No ICG-related complications occurred.

Conclusion

No complications occurred with ICG fluorescence in RvNOTES. It appears to be a safe option for ureteral localisation and preservation. ICG fluorescence is widely used in diverse medical specialities for identifying ureters during complex surgeries. Larger studies are needed to firmly establish its advantages in intraoperative ureteral visualisation during RvNOTES for deep infiltrative endometriosis.

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探索在子宫内膜异位症切除术中使用吲哚菁绿荧光术中输尿管可视化的可行性

背景评估在通过机器人经阴道自然腔道内窥镜手术（RvNOTES）切除子宫内膜异位症时使用吲哚菁绿（ICG）来识别和减少尿路损伤的可行性。方法我们在两家学术性三级医院开展了一项回顾性病例系列研究。我们对 53 例接受 RvNOTES 子宫切除术并计划切除子宫内膜异位症的患者进行了研究。结果研究涉及 53 名接受 RvNOTES 及 ICG 荧光子宫内膜异位症切除术的患者。患者平均年龄为（37.98 ± 6.65）岁。手术时间平均为（181.32 ± 53.94）分钟，失血量估计为（45.57 ± 33.62）毫升。术后平均住院时间为（0.23 ± 0.47）天。未发生 ICG 相关并发症。结论 RvNOTES 中的 ICG 荧光术未出现并发症。它似乎是输尿管定位和保留的安全选择。ICG 荧光技术被广泛应用于各种医学专科，在复杂的手术中识别输尿管。需要进行更大规模的研究，以确定ICG荧光在RvNOTES治疗深部浸润性子宫内膜异位症时术中输尿管显像的优势。

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来源期刊

International Journal of Medical Robotics and Computer Assisted Surgery 医学-外科

CiteScore

4.50

自引率

12.00%

发文量

131

审稿时长

6-12 weeks

期刊介绍： The International Journal of Medical Robotics and Computer Assisted Surgery provides a cross-disciplinary platform for presenting the latest developments in robotics and computer assisted technologies for medical applications. The journal publishes cutting-edge papers and expert reviews, complemented by commentaries, correspondence and conference highlights that stimulate discussion and exchange of ideas. Areas of interest include robotic surgery aids and systems, operative planning tools, medical imaging and visualisation, simulation and navigation, virtual reality, intuitive command and control systems, haptics and sensor technologies. In addition to research and surgical planning studies, the journal welcomes papers detailing clinical trials and applications of computer-assisted workflows and robotic systems in neurosurgery, urology, paediatric, orthopaedic, craniofacial, cardiovascular, thoraco-abdominal, musculoskeletal and visceral surgery. Articles providing critical analysis of clinical trials, assessment of the benefits and risks of the application of these technologies, commenting on ease of use, or addressing surgical education and training issues are also encouraged. The journal aims to foster a community that encompasses medical practitioners, researchers, and engineers and computer scientists developing robotic systems and computational tools in academic and commercial environments, with the intention of promoting and developing these exciting areas of medical technology.