Intraoperative Fluorescent Navigation of the Ureters, Vessels, and Nerves during Robot-Assisted Sacrocolpopexy
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patients
2.2. Surgical Interventions
3. Results
3.1. Baseline Characteristics
3.2. Intraoperative Characteristics
3.2.1. Images of Right Ureter Fluorescence
3.2.2. Appearances of MSA and SHN Visualized through ICG Fluorescence
3.2.3. ICG Images of the SVP
3.3. Surgical Outcomes
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variable | n = 15 |
---|---|
Age, years, median, and range | 63.5 (53–70) |
Vaginal parity, median, and range | 2 (1–3) |
BMI, kg/m2, mean ± SD | 23.5 ± 2.4 |
Menopause or perimenopause, n (%) | 15 (100%) |
Associated medical illness, n (%) | |
Hypertension | 12 (80%) |
Arrythmia | 2 (13.3%) |
Angina | 2 (13.3%) |
Early COPD | 1 (6.7%) |
Hyperlipidemia | 5 (33.3%) |
Fatty liver | 3 (20%) |
Previous pelvic surgery, n (%) | |
Total abdominal hysterectomy | 1 (6.7%) |
Salpingo-oophorectomy and myomectomy | 1 (6.7%) |
Previous midurethral sling | 1 (6.7%) |
Concomitant intra-abdominal pathology | 13 (86.7%) |
Fibroids or adenomyosis | 10 (66.7%) |
Benign ovarian cysts | 3 (20%) |
POP-Q at baseline ≥ IIb | |
Anterior | 15 (100%) |
Apical | 15 (100%) |
Posterior | 3 (20%) |
POP-Q staging, n (%) | |
Stage IIb | 6 (40%) |
Stage III | 5 (33.3%) |
Stage IV | 4 (26.7%) |
Variable | n = 15 |
---|---|
Visualization of the ureter | 15/15 (100%) |
Time from ICG injection to fluorescence | Immediately |
Duration of fluorescence (h) | >5 h |
Visualization of the MSA | 12/15 (80%) |
Time from ICG injection to fluorescence (s) | 43.7 (23–89) |
Duration of MSA fluorescence (s) | 104.3 (14–205) |
Visualization of the SHN | 11/15 (73.3%) |
Time from ICG injection to fluorescence (s) | 48.4 (28–89) |
Duration of SHN fluorescence (s) | 177.2 (49–316) |
Variables | n = 15 |
---|---|
Total operation time 1, (minutes), mean ± SD | 346 ± 37.9 |
Concomitant surgery, n (%) | 15 (100%) |
Total hysterectomy | 14 (93.3%) |
Adnexectomy | 14 (93.3%) |
Adhesiolysis | 9 (60%) |
Posterior colpoperineorrhaphy | 3 (20%) |
Estimated blood loss (mL), mean ± SD | 153.3 ± 69.4 |
Hemoglobin decrease (g/dL), mean ± SD | 1.57 |
Transfusion | 0 |
Hospital length of stay (days), median and range | 5 (4–7) |
Clavien–Dindo grade III or higher complications | 0 |
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Jun, H.S.; Lee, N.; Gil, B.; Jang, Y.; Yu, N.K.; Jung, Y.W.; Yun, B.S.; Kim, M.K.; Won, S.; Seong, S.J. Intraoperative Fluorescent Navigation of the Ureters, Vessels, and Nerves during Robot-Assisted Sacrocolpopexy. J. Pers. Med. 2024, 14, 827. https://doi.org/10.3390/jpm14080827
Jun HS, Lee N, Gil B, Jang Y, Yu NK, Jung YW, Yun BS, Kim MK, Won S, Seong SJ. Intraoperative Fluorescent Navigation of the Ureters, Vessels, and Nerves during Robot-Assisted Sacrocolpopexy. Journal of Personalized Medicine. 2024; 14(8):827. https://doi.org/10.3390/jpm14080827
Chicago/Turabian StyleJun, Hye Sun, Nara Lee, Bohye Gil, Yoon Jang, Na Kyung Yu, Yong Wook Jung, Bo Seong Yun, Mi Kyoung Kim, Seyeon Won, and Seok Ju Seong. 2024. "Intraoperative Fluorescent Navigation of the Ureters, Vessels, and Nerves during Robot-Assisted Sacrocolpopexy" Journal of Personalized Medicine 14, no. 8: 827. https://doi.org/10.3390/jpm14080827
APA StyleJun, H. S., Lee, N., Gil, B., Jang, Y., Yu, N. K., Jung, Y. W., Yun, B. S., Kim, M. K., Won, S., & Seong, S. J. (2024). Intraoperative Fluorescent Navigation of the Ureters, Vessels, and Nerves during Robot-Assisted Sacrocolpopexy. Journal of Personalized Medicine, 14(8), 827. https://doi.org/10.3390/jpm14080827