Abstract:
The application of indocyanine green (ICG) has recently been reported to aid in the resection of endometriosis in the bladder wall and/or involving the ureters. A symptomatic 41-year-old patient with dysmenorrhea and pollakisuria was referred to our tertiary center. Imaging revealed a 1.5-2 cm intramural endometriotic nodule in the posterior bladder wall. She was planned for robotic resection of the endometriotic nodule, under ICG guidance, together with a hysterectomy. After placement of double-J ureteral stents and clamping the bladder, perforation of the bladder mucosa could be avoided whilst performing a circumferential resection of the nodule. By clamping the bladder catheter after instillation of ICG, both the bladder wall thickness and ureters could be visualized with near-infrared imaging during robotic resection of the endometriotic nodule and hysterectomy. With the surgical approach described here, endometriotic nodules/tissue can be removed precisely with enlarged vision at the robot console, safely, and completely without damaging adjacent tissues.
摘要:
最近报道了吲哚菁绿(ICG)的应用有助于切除膀胱壁和/或累及输尿管的子宫内膜异位症。一名有症状的41岁痛经和尿频的患者被转诊到我们的三级中心。影像学检查显示膀胱后壁有1.5-2厘米的子宫内膜异位症结节。她计划用机器人切除子宫内膜异位结节,在ICG的指导下,还有子宫切除术.放置双J输尿管支架并夹住膀胱后,在进行结节的圆周切除时,可以避免膀胱粘膜穿孔。通过在滴注ICG后夹住膀胱导管,在机器人切除子宫内膜异位结节和子宫切除术期间,可以通过近红外成像观察膀胱壁厚度和输尿管.通过这里描述的手术方法,子宫内膜异位症结节/组织可以通过机器人控制台的扩大视野精确地移除,安全,并且完全不损伤邻近组织。