AB046. SOH22ABS034. Interureteric injection of indocyanine green for intraoperative identification of the ureter

Background: Injury to the urinary tract is a common complication of gynaecologic surgery, with ureteric injury occurring in up to 1.5% of cases, and bladder injury up to 1.8%. As the complexity of the surgery increases, so too does the likelihood of ureteric injury. This may result in serious complications, return to theatre, prolonged stay in hospital, and medico-legal issues. Complex cases that are complicated by previous surgery, adhesions, difficult anatomy, malignancy, or endometriosis can make identification of the ureter difficult. This extends length of surgery and time under anaesthetic, and adversely affects surgical efficiency. To counter these difficulties and improve patient outcomes, we have begun to introduce a novel technique to our hospital. In our initial test of feasibility, interureteric injection of indocyanine green (ICG) allowed for ready identification of the ureter at the time of an operative laparoscopic procedure.