机器人外科学杂志（中英文）2024，Vol.5Issue(3)：412-419,8.DOI:10.12180/j.issn.2096-7721.2024.03.017
吲哚菁绿近红外荧光显影技术在机器人辅助腹腔镜上尿路修复重建手术中的应用(附手术视频)
Application of indocyanine green and near-infrared fluorescence imaging in robot-assisted laparoscopic urinary tract repair and reconstruction surgery(with surgical video)
摘要
Abstract
Objective:To explore the feasibility and the clinical application value of indocyanine green(ICG)and near-infrared fluorescence(NIRF)imaging in robot-assisted laparoscopic upper urinary tract repair and reconstruction surgery.Methods:The clinical data of 8 patients who underwent ICG-guided robot-assisted laparoscopic upper urinary tract repair and reconstruction in the Second Hospital of Lanzhou University between March 2021 to October 2023 were retrospectively analyzed.ICG solution was injected into the 8 patients through nephrostomy tube and/or ureteral catheter during operation.Real-time fluorescence imaging technique was used to identify the ureter to help surgical decision-making.Patient characteristics,perioperative outcomes,and complications were analyzed.Results:All the 8 cases of surgery were successfully completed without conversion to laparotomy,including 3cases of pyeloplasty,2 cases of lingual mucosal graft ureteroplasty,1 case of ureteroureterostomy,1 case of bladder muscle flap ureteroplasty and 1 case of kidney autotransplantation.ICG-NIRF technology was used to accurately locate and separate the ureteral stenosis.The average operative time of the 8 patients was 257.5(140 to 330)min,and the average intraoperative blood loss was 55(5 to 150)ml.A child who underwent secondary pyeloplasty for intestinal rupture caused by severe colonic adhesion and mechanical injury.The ascending colon was repaired in one stage and healed well after surgery.The other patients recovered well after the operation,and no intraoperative or short-term postoperative complications occurred.The average follow-up time was 5.5(2 to 19)months,and no ICG side effect was found in the 8 patients.B-ultrasound of urinary system showed that hydronephrosis and obstruction were relieved 3 months after surgery in the 8 patients.Antegrade urography of urinary pelvis and ureter was performed in 3 patients 4 months after surgery,and the results indicated that the ureter was unobstructed and the fistula tube was removed.Conclusion:ICG real-time imaging technique is accurate and reliable in displaying ureter and stenosis during complex robotic upper urinary tract reconstruction surgery.The combination of ICG and NIRF in robot-assisted urologic surgery can achieve minimally invasive and accurate operation,which is worthy of clinical promotion.关键词
吲哚菁绿/舌黏膜补片/输尿管狭窄/自体肾移植/机器人辅助手术Key words
Indocyanine Green/Lingual Mucosal Graft/Ureteral Stricture/Kidney Autotransplantation/Robot-assisted Surgery分类
医药卫生引用本文复制引用
左佳乐,李笑然,何綦琪,马腾,石玮,包军胜..吲哚菁绿近红外荧光显影技术在机器人辅助腹腔镜上尿路修复重建手术中的应用(附手术视频)[J].机器人外科学杂志（中英文）,2024,5(3):412-419,8.基金项目
国家自然科学基金(82160146) （82160146）
兰州大学第二医院萃英科技创新计划项目(CY2020-MS08) （CY2020-MS08）
兰州大学第二医院萃英科技创新计划项目(CY2021-MS-A12) National Natural Science Foundation of China(82160146) （CY2021-MS-A12）
Cuiying Scientific and Technological Innovation Program of the Second Hospital of Lanzhou University(CY2020-MS08) （CY2020-MS08）
Cuiying Scientific and Technological Innovation Program of the Second Hospital of Lanzhou University(CY2021-MS-A12) （CY2021-MS-A12）
