Image-Navigation Surgery with Fluorescent Ureteral Catheter for the Anterior Lesion of the Low Rectal Cancer Requiring Prostate Shaving and Lateral Pelvic Lymph Node Dissection.

Several image navigation techniques can recognize the route of the urinary tract, but such techniques have not been widely accepted because they require special equipment or the specific adjustment of an indocyanine green reagent.[1-3]

Fluorescent ureteral catheter NIRC (Near Infrared Ray Catheter) sets are 6.0F catheters that allow continuous flow from renal calyces to an external collection bag. Such catheters contain fluorescent substances along their length that can be recognized by laparoscopic indocyanine green cameras, which are available from several companies and do not require the use of any other devices.

Prostate shaving is a surgical option based on a tumor’s response to chemoradiotherapy in T4b rectal cancer because pelvic exenteration for a male patient markedly decreases his quality of life.[4,5] In this procedure, it was not possible to recognize the prostatic urethra. Discerning the ureter during lateral pelvic lymph node dissection is also important to prevent injury.

In this report, we present a case of a 75-year-old man with ycT4b (prostate) N0M1b (liver, inguinal lymph node, right lateral pelvic lymph node) Stage IVB low rectal cancer who underwent an abdominoperineal resection with prostate shaving and right lateral pelvic lymph node dissection. (See Video at http://links.lww.com/DCR/B437.)