Indocyanine Green Fluorescence-Guided Laparoscopic Ureterolysis for Complex Gynecological Surgeries

Background: To identify and safeguard the ureters of patients with deep infiltrating endometriosis or complex pelvic adhesion (obliterated cul-de-sac) using indocyanine green (ICG) during laparoscopic surgery. Methods: Stepwise surgical demonstration narrated video footage. The stepwise procedures were: (1) Explore abdominal cavity, resect adhesions, remove right ovarian endometrioma cysts, open peritoneum to locate fluorescence. (2) Place bilateral 5-Fr ureteral catheters through cystoscope, inject ICG retrogradely, clip catheter retain ICG. (3) Identify course perform ureterolysis real-time visualization under Near-infrared Resect para-ureteral other endometriosis. Results: patient was discharged on 4th postoperative day satisfactory effect without any complications. Conclusions: For gynecologic surgeries whereby might be challenging, fluorescence imaging could used quickly ureter, prevent injury reduce risks perioperative This case demonstrates that intraureteral provided quick ureter allowed surgeons safely ureterolysis. proposed technique considered in gynecological cancer, floor disorder