Best practices in near-infrared fluorescence imaging with indocyanine green (NIRF/ICG)-guided robotic urologic surgery: a systematic review-based expert consensus

Cacciamani, G.E.; Shakir, A.; Tafuri, A.; Gill, K.; Han, J.; Ahmadi, N.; ... ; Abreu, A.L.D. (2020)

Article / Letter to editor

Purpose The aim of the present study is to investigate the impact of the near-infrared (NIRF) technology with indocyanine green (ICG) in robotic urologic surgery by performing a systematic literature review and to provide evidence-based expert recommendations on best practices in this field. Methods All English language publications on NIRF/ICG-guided robotic urologic procedures were evaluated. We followed the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analyses) statement to evaluate PubMed(R), Scopus(R) and Web of Science (TM) databases (up to April 2019). Experts in the field provided detailed pictures and intraoperative video-clips of different NIRF/ICG-guided robotic surgeries with recommendations for each procedure. A unique QRcode was generated and linked to each underlying video-clip. This new exclusive feature makes the present the first "dynamic paper" that merges text and figure description with their own video providing readers an innovative, immersive, high-quality and user-friendly experience. Results Our electronic search identified a total of 576 papers. Of these, 36 studies included in the present systematic review reporting the use of NIRF/ICG in robotic partial nephrectomy (n = 13), robotic radical prostatectomy and lymphadenectomy (n = 7), robotic ureteral re-implantation and reconstruction (n = 5), robotic adrenalectomy (n = 4), robotic radical cystectomy (n = 3), penectomy and robotic inguinal lymphadenectomy (n = 2), robotic simple prostatectomy (n = 1), robotic kidney transplantation (n = 1) and robotic sacrocolpopexy (n = 1). Conclusion NIRF/ICG technology has now emerged as a safe, feasible and useful tool that may facilitate urologic robotic surgery. It has been shown to improve the identification of key anatomical landmarks and pathological structures for oncological and non-oncological procedures. Level of evidence is predominantly low. Larger series with longer follow-up are needed, especially in assessing the quality of the nodal dissection and the feasibility of the identification of sentinel nodes and the impact of these novel technologies on long-term oncological and functional outcomes.

• ICG
• Indocyanine green
• NIRF
• Near-infrared fluorescence
• Firefly
• robotic surgery
• Urology
• Robotic partial nephrectomy
• Robotic adrenalectomy
• Robotic radical prostatectomy
• Lymphadenectomy
• Robotic radical cystectomy

• All authors: Cacciamani, G.E.; Shakir, A.; Tafuri, A.; Gill, K.; Han, J.; Ahmadi, N.; Hueber, P.A.; Gallucci, M.; Simone, G.; Campi, R.; Vignolini, G.; Huang, W.C.; Taylor, J.; Becher, E.; Leeuwen, F.W.B. van; Poel, H.G. van der; Velet, L.P.; Hemal, A.K.; Breda, A.; Autorino, R.; Sotelo, R.; Aron, M.; Desai, M.M.; Abreu, A.L.D.
• Date: 2020-04-01
• Journal: World Journal of Urology
• Volume: 38
• Issue: 4
• Pages: 883 - 896
• DOI: doi:10.1007/s00345-019-02870-z
• Link: https://link.springer.com/article/10.1007/s00345-019-02870-z