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Near Infrared Fluorescence Applications in Urinary Bladder Cancer

  • Wojciech PolomEmail author
  • Karol Polom
  • Marcin Matuszewski
Chapter
  • 8 Downloads

Abstract

Bladder cancer is a common malignancy. Cystectomy with urinary diversion and pelvic lymph node dissection is the best treatment method when the bladder wall is invaded. Recently, cisplatin-based neoadjuvant chemotherapy has been added to the treatment of selected groups of patients, improving their 5-year survival rate. Conventional methods of bladder removal with a template lymphadenectomy do not always bring satisfactory results as far as cancer-free survival is concerned. Improving visualization of the lymphatic vessels can advance the procedure of removing micrometastases, thus offering better treatment results. New methods of image-guided surgery with the use of near infrared camera systems and fluorescent dyes—such as indocyanine green, or ICG—have emerged, allowing for live intraoperative visualization of the bladder tumor site, personalized estimation of the lymphatic flow from the tumor site, and safe bowel preparation, especially in laparoscopic and robotic operations. The technology of infrared fluorescence imaging is developing, and its application in bladder cancer, as well as in other malignancies, is evolving rapidly. New systems and new techniques are used to help prepare a surgeon to the operation by customizing every case and thus limiting postoperative complications. There are still some issues regarding techniques involving bladder cancer surgery fluorescence that need to be solved, such as tissue penetration of fluorescence in obese patients and prolonged procedure; still, the benefits seem to be very encouraging.

Keywords

Bladder cancer Urinary diversion Lymphadenectomy Fluorescence Near infrared Image-guided surgery Indocyanine green Sentinel lymph node 

Supplementary material

Video 23.1

Indocyanine green (ICG) injection in cystoscopy (MOV 108189 kb)

Video 23.2

Injection site bladder (WMV 4322 kb)

Video 23.3

Sentinel lymph nodes identification (WMV 5407 kb)

Video 23.4

Sentinel lymph node after excision (WMV 7044 kb)

Video 23.5

Ileal conduit angiography (WMV 7691 kb)

Video 23.6

Camera position during open procedure (MOV 10672 kb)

Video 23.7

Indocyanine green (ICG) spillage and field contamination (WMV 6719 kb)

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Wojciech Polom
    • 1
    Email author
  • Karol Polom
    • 2
  • Marcin Matuszewski
    • 1
  1. 1.Department of UrologyMedical University of GdanskGdanskPoland
  2. 2.Department of Oncological SurgeryMedical University of GdanskGdanskPoland

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