Application of Near-Infrared Fluorescence Imaging Navigation With Indocyanine Green and Near-Infrared Ray Catheter During Robotic Ureteral Reconstruction.

Near-infrared fluorescence (NIRF) imaging navigation facilitates precise identification of the affected segment and preservation of vascularization in the ureter and surrounding organs. We report our experience using indocyanine green (ICG) and a ureteral near-infrared ray catheter (NIRC) during robot-assisted ureteral reconstruction. Case 1: A patient with a 1.5 cm right upper ureteral stricture following ureteroscopic lithotripsy underwent robot-assisted ureteroureterostomy. Placement of an NIRC just below the stricture site under fluoroscopy enabled precise intraoperative identification. Additionally, intravenous ICG injection allowed assessment of blood flow around the stricture site. Case 2: A patient with a left lower ureteral tumor underwent robot-assisted distal ureterectomy and ureteroneocystostomy with Boari flap. Placement of an NIRC just below the proximal tumor site facilitated accurate tumor localization and ureteral resection. Intravenous ICG administration visualized the vascularity of both the ureter and bladder flap. NIRF imaging navigation with ICG and NIRC can improve overall outcomes in robotic ureteral reconstruction.