Application of indocyanine green fluorescence for ureter imaging: review

Abstract

Introduction. Indocyanine green has been used in medicine for more than 70 years in cardio-thoracic surgery, hepatobiliary and colorectal surgery, urology, gynecology, transplantology, etc. This review based on literature dates describing the use of ICG for intraoperative imaging and evaluation of the ureteral perfusion. Method. The research searched in the electronic database PubMed, Scopus, Elsevier, Springer, and Web of Science between January 2000 and December 2020, using the following search terms: ICG imaging, ureteral vessels. Additional literature data identified from separately published sources. Results. There are 21 articles were obtained in the specified database: 9 - with intravenous ICG, 12 - with intraureteral administration. The use of intravenous ICG followed by next clinical situation: ureteral imaging is described for ureteral strictures, for isolation and preservation of the ureteral branch of the uterine artery during radical hysterectomy, for robotic radical cystectomy with ureteroenterostomy, for laparoscopic removal of ureteral endometriosis, for evaluation of ureteral perfusion during kidney transplantation, and for identification and prevention of ureteral damage during pelvic surgery in patients with colorectal tumors and gynecological pathologies. Conclusions. Both intravenous and intraureteral ICG imaging are safe, easy to perform, and easily reproducible. It allows objectively identifying the degree of perfusion of the ureteral wall, clearly determining the boundaries of the stricture. It is effectively helps in the prevention of ureteral wall damage in extraurinal surgical interventions.