V4-07 USE OF INTRA-OPERATIVE INDOCYANINE GREEN AND FIREFLY® TECHNOLOGY TO VISUALIZE THE “LANDMARK ARTERY” FOR NERVE SPARING ROBOT ASSISTED RADICAL PROSTATECTOMY

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You have accessJournal of UrologyRobotics – Prostate/Novel Imaging1 Apr 2015V4-07 USE OF INTRA-OPERATIVE INDOCYANINE GREEN AND FIREFLY® TECHNOLOGY TO VISUALIZE THE “LANDMARK ARTERY” FOR NERVE SPARING ROBOT ASSISTED RADICAL PROSTATECTOMY Anup Kumar, Srinivas Samavedi, Anthony Bates, Rafael Coelho, Bernardo Rocco, Jeff Marquinez, Cathy Jenson, Kenneth Palmer, and Vipul Patel Anup KumarAnup Kumar More articles by this author , Srinivas SamavediSrinivas Samavedi More articles by this author , Anthony BatesAnthony Bates More articles by this author , Rafael CoelhoRafael Coelho More articles by this author , Bernardo RoccoBernardo Rocco More articles by this author , Jeff MarquinezJeff Marquinez More articles by this author , Cathy JensonCathy Jenson More articles by this author , Kenneth PalmerKenneth Palmer More articles by this author , and Vipul PatelVipul Patel More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.719AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The “Landmark Artery” has been shown to be a valuable landmark during nerve sparing radical prostatectomy in improving the quality of the neurovascular bundle (NVB) preservation. Sometimes this landmark can be challenging to find due to inexperience of the surgeon or anatomical challenges. Our goal was to evaluate an innovative intra-operative tool, Near-infrared (NIR) Firefly® technology in conjunction with intravenous indocyanine green (ICG) to help identification of this “Landmark Artery ”during nerve sparing(NS) robot assisted radical prostatectomy(RARP). METHODS Ten patients underwent nerve sparing RARP. Prior to clamping the pedicle or dissection of the NVB,0.75 cc of ICG was given. The Firefly® technology was engaged on the robotic console and a period of 20-40 seconds was allowed for the ICG to enter the vascular system. The landmark artery was then observed bilaterally. After this time period we switched back to the non-firefly mode and proceeded with out normal NS operation. Data was collected regarding the % chance of being able to visualize this landmark in the 10 patients. RESULTS In ten patients 20 NVB were examined with the ICG and Firefly® technology. The landmark prostatic artery and its pathway could be identified in 17/20 NVB (85%). In the other 3 patients we were unable to visualize the artery as it was underneath some large veins. The artery was seen visually in these patients during the normal NS surgery. The use of ICG did not significantly increase operative time or result in any immediate or long term complications. CONCLUSIONS The use of ICG and Firefly® technology during NS radical prostatectomy has the potential to more accurately and more frequently identify the landmark prostatic artery that runs along the NVB. For experienced and novice surgeons the pathway of this artery is valuable for NS and can help improve nerve sparing quality. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e406 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Anup Kumar More articles by this author Srinivas Samavedi More articles by this author Anthony Bates More articles by this author Rafael Coelho More articles by this author Bernardo Rocco More articles by this author Jeff Marquinez More articles by this author Cathy Jenson More articles by this author Kenneth Palmer More articles by this author Vipul Patel More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...