Real-Time Near-Infrared ICG Fluorescence to Aid in Deep Infiltrating Endometriosis Bladder Nodule Shaving

Abstract

Study Objective

To present a surgical observation while using NIR-ICG technology. And furtherly, how this observation translates in a potential application for Endometriosis surgery.

Design

Descriptive observational study.

Setting

Tertiary private clinic.

Patients or Participants

Two patients with Deep Infiltrating Endometriosis (DIE) nodules affecting the bladder.

Interventions

Bladder shaving aided by ICG staining after ureteral catheterization for parametrial and posterior compartment endometriosis. After retrieving catheters, Bladder urothelium stains and helps identifying urothelial limits facilitating bladder shaving without entering the bladder's lumen.

Measurements and Main Results

This is a proof of concept, a feasibility study.

Conclusion

As DIE nodules of the bladder come from the peritoneal side of the bladder, in the same way as deep rectal nodules, shaving is a surgical gesture with less potential complications compared to full thickness bladder resections. ICG-stained bladder mucosa is clearly visible making it possible to avoid entering the bladder´s lumen which can potentially decrease the need for post-operatory use of bladder catheter.