Robotic-assisted Laparoscopic Ureterolysis for Deep Infiltrating Endometriosis using Indocyanine Green Under Near-Infrared Fluorescence

Brooke Thigpen, Koythong T, Tamisa Koythong, Guan X, Xiaoming Guan
Journal of Minimally Invasive Gynecology · 2022 · vol. 29(5) , pp. 586–587 · doi:10.1016/j.jmig.2022.01.018 · PMID:35151876 · W4210988258
Case report OA: closed CC0 ⤵ 9 in-corpus citations
View on OpenAlex View on PubMed View at publisher
⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-07-28 ⓘ

This case demonstrates the successful use of intraureteral indocyanine green and near-infrared fluorescence to identify ureters for robotic-assisted ureterolysis in a patient with deep infiltrating endometriosis.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

Abstract

STUDY OBJECTIVE: To demonstrate safe identification of ureters in patients with deep infiltrating endometriosis or severe adhesive disease using indocyanine green (ICG) under near-infrared fluorescence (NIRF) on the robotic platform. DESIGN: Stepwise demonstration using narrated video footage. SETTING: An academic tertiary care hospital. A 43 year old G0 with stage IV endometriosis presented with chronic pelvic pain. Her surgical history is notable for 2 aborted hysterectomies due to severe adhesive disease, despite extensive lysis of adhesions. She desired surgical intervention. INTERVENTIONS: In cases of stage IV endometriosis, localizing the ureters can be challenging due to severe adhesive disease, surrounding fibrotic tissue, and distorted anatomy. Intravenous ICG has previously been described to assist with resection of endometriosis [1-3]. Alternatively, we describe a technique that allows for easier identification of ureters using ICG injection retrogradely in ureteral stents while visualized under NIRF [4,5]. IN SUMMARY: The patient underwent robotic-assisted total laparoscopic hysterectomy, bilateral salpingo-oophorectomy, bilateral ureterolysis, low anterior bowel resection with primary anastomosis, and resection of endometriosis without intraoperative complications or ureteral injury. Her postoperative course was unremarkable. At her 3 week postoperative visit, pelvic pain had completely resolved. CONCLUSIONS: This case demonstrates the use of intraureteral ICG and NIRF to identify the ureters and perform ureterolysis in cases of deep infiltrative endometriosis.

My notes (saved in your browser only)

Condition tags

endometriosischronic_pelvic_paindie_deep_infiltrating

MeSH descriptors

Endometriosis Endometriosis Endometriosis Laparoscopy Laparoscopy Laparoscopy Robotic Surgical Procedures Robotic Surgical Procedures Robotic Surgical Procedures Ureter Ureter Ureter Adult Adult Female Female Humans Humans Indocyanine Green Indocyanine Green

Citation neighborhood (2-hop)

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (5)

Cited by (9)

Source provenance

europepmc
last seen: 2026-10-16T06:09:50.462052+00:00
openalex
last seen: 2026-06-04T00:00:01.174412+00:00
pubmed
last seen: 2026-10-08T21:33:56.888256+00:00
unpaywall
last seen: 2026-10-16T06:24:35.758740+00:00
License: CC0 · commercial use OK