Background: Intraoperative indocyanine green (ICG) near-infrared fluorescence guidance is a type of optical imaging technology now available to facilitate a better understanding of surgical landmarks. This case describes use of this technique during lower-pole heminephrectomy for a patient with duplex kidney. Case Presentation: A 50-year-old woman with a left duplex system and lower-pole kidney infection underwent a laparoscopic transperitoneal lower-pole heminephrectomy. After exposing the left renal pedicles, ICG was administered through a ureteral stent inserted into the upper calix; the nonaffected ureter could be viewed, which enabled us to dissect the affected ureter connected to the lower-pole pelvis. Next, intravenous ICG administration revealed that the lower-pole kidney blood flow was not reduced. This finding prompted us to clamp the main renal artery. Furthermore, ICG injection through a nephrostomy tube helped to observe the lower-pole kidney collecting system and predict the parenchymal dissection plane location between the upper- and lower-pole kidneys. We effectively performed a lower-pole heminephrectomy through complete lower-pole urinary tract resection and maximal upper-pole parenchyma preservation. Conclusion: ICG fluorescence by intravenous and intraureteral administration observes relevant anatomy intraoperatively and is beneficial in patients who undergo a lower-pole heminephrectomy for duplex kidney. Copyright 2020, Mary Ann Liebert, Inc., publishers.
Background: Intraoperative indocyanine green (ICG) near-infrared fluorescence guidance is a type of optical imaging technology now available to facilitate a better understanding of surgical landmarks. This case describes use of this technique during lower-pole heminephrectomy for a patient with duplex kidney. Case Presentation: A 50-year-old woman with a left duplex system and lower-pole kidney infection underwent a laparoscopic transperitoneal lower-pole heminephrectomy. After exposing the left renal pedicles, ICG was administered through a ureteral stent inserted into the upper calix; the nonaffected ureter could be viewed, which enabled us to dissect the affected ureter connected to the lower-pole pelvis. Next, intravenous ICG administration revealed that the lower-pole kidney blood flow was not reduced. This finding prompted us to clamp the main renal artery. Furthermore, ICG injection through a nephrostomy tube helped to observe the lower-pole kidney collecting system and predict the parenchymal dissection plane location between the upper- and lower-pole kidneys. We effectively performed a lower-pole heminephrectomy through complete lower-pole urinary tract resection and maximal upper-pole parenchyma preservation. Conclusion: ICG fluorescence by intravenous and intraureteral administration observes relevant anatomy intraoperatively and is beneficial in patients who undergo a lower-pole heminephrectomy for duplex kidney. Copyright 2020, Mary Ann Liebert, Inc., publishers.
Authors: Giovanni E Cacciamani; A Shakir; A Tafuri; K Gill; J Han; N Ahmadi; P A Hueber; M Gallucci; G Simone; R Campi; G Vignolini; W C Huang; J Taylor; E Becher; F W B Van Leeuwen; H G Van Der Poel; L P Velet; A K Hemal; A Breda; R Autorino; R Sotelo; M Aron; M M Desai; A L De Castro Abreu Journal: World J Urol Date: 2019-07-08 Impact factor: 4.226
Authors: Charlotte K Roberts; Jonathan S Ellison; Omar Aboumarzouk; Mohamed Abd-Alazeez; Francis X Keeley Journal: Can J Urol Date: 2018-10 Impact factor: 1.344