Intraureteral Instillation of Indocyanine Green for Intraoperative Identification of the Ureter During Laparoscopy

jpedsurg.org

Indocyanine green (ICG) is an FDA approved, well tolerated, inexpensive tricarbocyanine fluorophore that is being increasingly used in pediatric surgery and urology [1]. It is a fluorescent anion which is excitable at a light wavelength of 750–810 nm by the near infrared spectrum and hence fluoresces when infrared light is applied to it [2]. We utilize these fluorescent properties of ICG to allow the laparoscopic identification of an upper pole ureter of a duplex kidney following cystoscopic instillation of ICG to its corresponding lower moiety ureter.

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Article · Dec 2024 · 1 min read

In brief

This technique demonstrates intraoperative ureter visualization using indocyanine green (ICG) fluorescence during laparoscopic procedures for duplex kidney systems. ICG is instilled cystoscopically into the lower moiety ureter, enabling near-infrared identification of the upper pole ureter to prevent inadvertent injury during surgery.

ICG is FDA-approved, well-tolerated, and cost-effective for pediatric surgical applications
ICG fluoresces under near-infrared light (750-810nm), enabling real-time visualization during laparoscopy
Cystoscopic ICG instillation into lower moiety ureter allows identification of upper pole ureter in duplex kidney
Near-infrared fluorescence imaging enhances intraoperative ureter identification and reduces injury risk

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