Ureteric injury is a feared complication during laparoscopic surgery. However, the majority of iatrogenic ureteral injuries are not recognized during the surgical procedure, which may lead to worse postoperative outcomes.
Intraoperative fluorescence ureteral identification with preoperative optical dye administration is a new technique for easier and earlier intraoperative visualization of the ureter. Therefore, it could improve the safety and efficiency of laparoscopic procedures.
In this chapter, we describe the technique and outline the dyes that have been studied to improve intraoperative recognition of the ureters during laparoscopic surgery. In the video, we demonstrate the use of three pre-clinical dyes for ureteral identification in a real-life pig model.
While several dyes in this chapter and in the video show promising results, the findings should be regarded as preliminary, indicating possible application in clinical settings. Current and future studies are necessary to validate the applicability of the technique.
Fluorescence imaging Ureteral visualization Fluorescent dyes Laparoscopic surgery Near-infrared
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Demonstration of successful ureter identification using near-infrared fluorescence imaging in a real-life pig model (MP4 521015 kb)
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