Using Indocyanine Green and Near-Infrared Fluorescence Technology to Identify the “Landmark Artery” During Robot-Assisted Radical Prostatectomy

KumarAnup,; SamavediSrinivas,; BatesAnthony,; CoelhoRafael,; RoccoBernardo,; MarquinezJeff,; PalmerKenneth, J; PatelVipul, R

doi:10.1089/vid.2014.0071

Cited by 13 publications

(7 citation statements)

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“…Our study, on a limited number of patients, compared with that of Kumar in 2015, has a better percentage of the neurovascular bundle identification (100% vs. 85%). Like in the study by Kumar et al, in our experience, the use of ICG did not significantly increase the operative time and did not result in complications (11).…”

Section: Discussionsupporting

confidence: 75%

Robot-assisted nerve-sparing radical prostatectomy using near-infrared fluorescence technology and indocyanine green: initial experience

et al. 2018

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Section: Discussionsupporting

confidence: 75%

Robot-assisted nerve-sparing radical prostatectomy using near-infrared fluorescence technology and indocyanine green: initial experience

et al. 2018

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“…Additionally, more prospective, randomised, and adequately powered studies are required to reveal the true potential of this surgical technological innovation. Kumar et al highlighted the importance of the prostatic landmark artery (LA) in nerve-sparing RARP [19].…”

Section: Discussionmentioning

confidence: 99%

Intraoperative angiography of the neurovascular bundle using indocyanine green and near-infrared fluorescence improves anatomical dissection during robot-assisted radical prostatectomy: initial clinical experience

et al. 2022

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Background: Landmark artery identi cation in the neurovascular bundle (NVB) is important for nervesparing in radical prostatectomy. We aimed to investigate intraoperative angiography using indocyanine green and near-infrared uorescence (ICG-NIRF) during robot-assisted radical prostatectomy (RARP) to identify the NVB, visualise vascularisation and haemostasis, and preserve erectile function.Methods: Retrospective, unicentric study of 91 consecutive localised prostate cancer RARP patients (stage T1/T2, prostate speci c antigen <10 ng/ml) who underwent ICG-NIRF angiography in France (2016)(2017)(2018)(2019)(2020)(2021). When ready to dissect the NVB, the anaesthesiologist intravenously injected ICG (3 ml); the surgeon used alternating standard light or uorescence to optimise NVB visualisation and facilitate microdissection. Primary outcomes: safety and feasibility of ICG-NIRF. Secondary outcomes: functional erectile dysfunction (Sexual Health Inventory for Men questionnaire) over 9 months, proportion of bilateral NVBs identi ed, ICG-related complications. Standard descriptive statistics were used; t-test determined the signi cance of changes in SHIM scores versus baseline.Results: Ninety-one patients received intraoperative angiography. The NVB was identi ed in all cases, without di culties. No ICG-related complications or allergies were observed. There was no signi cant difference in the SHIM score at 9 months compared with baseline (p=0.331), and erectile dysfunction returned to baseline levels in almost all patients.Conclusions: Intraoperative, real-time ICG-NIRF angiography is simple, non-invasive, and improves identi cation of key anatomical landmarks to optimise micropreservation of the NVB during RARP and preserve erectile function. Larger clinical studies should con rm preliminary results.

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“…Kumar et al proposed the use of near-infrared fluorescence (NIRF) and indocyanine green (ICG) for identifying the LA and performed a prospective case series examining the usefulness of this technology during ten cases of RARP. According to the authors, the LA and its course were identified in 85% of cases, without causing any complications or increasing the operating time [ 70 ].…”

Section: The Role Of Near-infrared Fluorescence (Nirf) and Indocyanin...mentioning

confidence: 99%

Different Nerve-Sparing Techniques during Radical Prostatectomy and Their Impact on Functional Outcomes

Kyriazis

Spinos

Tsaturyan

et al. 2022

Cancers

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The purpose of this narrative review is to describe the different nerve-sparing techniques applied during radical prostatectomy and document their functional impact on postoperative outcomes. We performed a PubMed search of the literature using the keywords “nerve-sparing”, “techniques”, “prostatectomy” and “outcomes”. Other potentially eligible studies were retrieved using the reference list of the included studies. Nerve-sparing techniques can be distinguished based on the fascial planes of dissection (intrafascial, interfascial or extrafascial), the direction of dissection (retrograde or antegrade), the timing of the neurovascular bundle dissection off the prostate (early vs. late release), the use of cautery, the application of traction and the number of the neurovascular bundles which are preserved. Despite this rough categorisation, many techniques have been developed which cannot be integrated in one of the categories described above. Moreover, emerging technologies have entered the nerve-sparing field, making its future even more promising. Bilateral nerve-sparing of maximal extent, athermal dissection of the neurovascular bundles with avoidance of traction and utilization of the correct planes remain the basic principles for achieving optimum functional outcomes. Given that potency and continence outcomes after radical prostatectomy are multifactorial endpoints in addition to the difficulty in their postoperative assessment and the well-documented discrepancy existing in their definition, safe conclusions about the superiority of one technique over the other cannot be easily drawn. Further studies, comparing the different nerve-sparing techniques, are necessary.

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Using Indocyanine Green and Near-Infrared Fluorescence Technology to Identify the “Landmark Artery” During Robot-Assisted Radical Prostatectomy

Cited by 13 publications

References 0 publications

Robot-assisted nerve-sparing radical prostatectomy using near-infrared fluorescence technology and indocyanine green: initial experience

Robot-assisted nerve-sparing radical prostatectomy using near-infrared fluorescence technology and indocyanine green: initial experience

Intraoperative angiography of the neurovascular bundle using indocyanine green and near-infrared fluorescence improves anatomical dissection during robot-assisted radical prostatectomy: initial clinical experience

Different Nerve-Sparing Techniques during Radical Prostatectomy and Their Impact on Functional Outcomes

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