Resident Westchester Medical Center, New York Medical College
Introduction: We report the use of indocyanine green (ICG) in a pediatric patient undergoing heminephrectomy of a duplicated collecting system. This technique may offer several advantages in that it is safe and reliable way to delineate anatomy and collecting system integrity. This may be extrapolated for other complex anatomical surgical cases.
Methods: A 16-year-old girl presented with complaints of constant urinary leakage. She underwent renal bladder ultrasound, magnetic resonance imaging, and cystogram which showed a duplicated collecting system and ectopic ureter.
Results: We performed a four-arm multiport robotic upper pole heminephrectomy. The surgical procedure was carried out as previously described in the literature. Twenty milliliters of diluted ICG was injected through a 5Fr open-ended catheter placed in the functioning lower pole segment of the kidney. During excision of the non-functioning upper pole, the ICG helped to illuminate the surgical margins and ensure that healthy renal parenchyma was spared and that there was no urinary leakage following upper pole excision and lower pole renorrhaphy.
Conclusions: To our knowledge we report the first time use of indocyanine green (ICG) in a pediatric patient undergoing heminephrectomy of a duplicated collecting system. Instillation of ICG for complicated anatomical surgical procedures is safe to use and can be efficacious in renal sparing procedures.