Robot-assisted modified radical hysterectomy with removal of lymphatic vessel using indocyanine green: A new method

Int J Med Robot. 2022 Dec;18(6):e2451. doi: 10.1002/rcs.2451. Epub 2022 Aug 19.

Abstract

Background: The sentinel lymph node (SLN) procedures using indocyanine green (ICG) have recently been performed worldwide. The aim of this study was to emphasise the safety of robot-assisted modified radical hysterectomy (RAMRH) with removal of the lymphatic vessels (RLV) using ICG in endometrial cancer according to a single surgeon's experience.

Methods: Robot-assisted modified radical hysterectomy with RLV using ICG was performed in patients with endometrial cancer. We compared 34 cases of RAMRH with RLV, with 54 patients without RLV.

Results: The median (interquartile range) time for the procedure did not differ between the RAMRH with and without RLV groups (88 [80-114] vs. 88 [79-104] min, p = 0.7). The success rate of RLV was 100% when SLNs were detected.

Conclusion: Robot-assisted modified radical hysterectomy with RLV using ICG can completely dissect tissue from the uterus, including lymphatic vessels. This procedure using a robotic system with ICG, is simple and does not require additional time.

Keywords: endometrial cancer; indocyanine green; lymphatic vessel; robot-assisted hysterectomy; sentinel lymph node.

MeSH terms

  • Coloring Agents
  • Endometrial Neoplasms* / surgery
  • Female
  • Humans
  • Hysterectomy / methods
  • Indocyanine Green
  • Lymphatic Vessels* / pathology
  • Robotics*
  • Sentinel Lymph Node Biopsy / methods

Substances

  • Indocyanine Green
  • Coloring Agents