Laparoscopic visualisation of the ureters using near-infrared fluorescence imaging after retrograde indocyanine green injection in deep infiltrating endometriosis: the LAVIC trial

Objective To evaluate the feasibility and safety of intraureteral indocyanine green fluorescence for real-time ureter visualisation during laparoscopic surgery for deep infiltrating endometriosis.

In this prospective, single-arm feasibility study, premenopausal women undergoing minimally invasive surgery for suspected deep infiltrating endometriosis received bilateral retrograde intraureteral indocyanine green following laparoscopic confirmation of the disease. Near-infrared fluorescence imaging was used for real-time ureteral visualisation. The primary outcome was the rate of successful ureteral visualisation. Secondary outcomes included fluorescence characteristics, the extent of ureterolysis, and procedure-related adverse events. Data were analysed primarily using descriptive statistics, with exploratory analyses performed where appropriate.

Fifty-one patients with a mean age of 36 years were included. The mean duration of surgery was 217.3 ± 81.1 min. The mean duration of cystoscopy was 7.0 ± 5.0 min, and for intraureteral ICG injection 4.3 ± 3.3 min. Bilateral ureteral fluorescence was achieved in 50 of 51 patients (98%). Visualisation was immediate in all cases and persisted throughout surgery. Ureterolysis was required in 45% of patients. No ureteral injuries or ICG-related complications occurred.

Intraureteral ICG fluorescence appears feasible for real-time ureteral visualisation during complex surgery for deep infiltrating endometriosis. No adverse events attributable to intraureteral ICG administration were observed; however, its clinical utility requires further evaluation in comparative studies. Trial registration The trial protocol is registered at clinicaltrials.gov, NCT05206279 Similar content being viewed by others Funding Open access funding provided by University of Bern. The material costs associated with the study and the applications were funded from internal research grants and did not receive any external or company-specific funding. The work carried out by the staff members was not remunerated. Author information Authors and Affiliations Corresponding authors Ethics declarations Conflict of interest The authors have no relevant financial or non-financial interests to disclose. Ethical approval This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the local Ethics Committee (Kantonale Ethikkommission Bern) (Project ID 2021–02010). The use of intraureteral ICG was approved by Swissmedic, the national committee for medical substances and devices. Informed consent Informed consent was obtained from all individual participants included in the study. Additional information Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Rights and permissions Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. About this article Cite this article Vaineau, C., Schlatter, B., Imboden, S. et al. Laparoscopic visualisation of the ureters using near-infrared fluorescence imaging after retrograde indocyanine green injection in deep infiltrating endometriosis: the LAVIC trial. Arch Gynecol Obstet (2026). https://doi.org/10.1007/s00404-026-08559-0 Received: Accepted: Published: DOI: https://doi.org/10.1007/s00404-026-08559-0