Intraoperative indocyanine green fluorescence navigation in a robot-assisted partial nephrectomy for a large renal cell carcinoma in a horseshoe kidney

BMJ Case Rep. 2022 Jun 20;15(6):e248323. doi: 10.1136/bcr-2021-248323.

Abstract

A man in his 60s was referred to the urology department with an incidental finding of large 75 mm mass within a horseshoe kidney. CT imaging highlighted the well-known aberrant arterial anatomy seen in horseshoe kidney which often causes significant surgical challenges.After careful preoperative planning, the mass was resected successfully during a robot-assisted partial nephrectomy. Intraoperatively, indocyanine green fluorescence navigation helped to confirm arteries supplying area of resection were appropriately clamped, allowing for safe resection of the mass. Histology revealed a chromophobe renal cell carcinoma with clear margins. The patient was discharged on day 4 postoperatively and continues to be cancer free on routine surveillance imaging.

Keywords: Cancer intervention; Renal intervention; Urinary and genital tract disorders; Urological surgery.

Publication types

  • Case Reports

MeSH terms

  • Carcinoma, Renal Cell* / complications
  • Carcinoma, Renal Cell* / diagnostic imaging
  • Carcinoma, Renal Cell* / surgery
  • Fluorescence
  • Fused Kidney* / surgery
  • Humans
  • Indocyanine Green
  • Kidney Neoplasms* / complications
  • Kidney Neoplasms* / diagnostic imaging
  • Kidney Neoplasms* / surgery
  • Male
  • Nephrectomy / methods
  • Robotics*

Substances

  • Indocyanine Green