The Use of Indocyanine Green in Robot Assisted Urology

Tissue vascularization is of outmost importance in reconstructive surgery in order to obtain a successful and long-lasting functional outcome. Intraoperative near-infrared fluorescence (NIRF) after the injection of indocyanine green (ICG) has emerged as a useful tool to assess tissue vitality and to facilitate structures identification especially in complex cases as in re-do surgeries or patients previously subjected to radiotherapy. ICG is the most commonly employed fluorescent dye and it can be administered both through intravenous injection (i.v.) or intraluminal (intraureteral or in the urinary diversion) to precisely identify the structures lumen and path. Many technologies have been developed to detect ICG fluorescence both in laparoscopic and robotic setting. The applications of this incredibly versatile dye are illustrated in this chapter to show the advantages that ICG could bring to all these surgical procedures from the upper to the lower urinary tract.