Real-time intraoperative ureteral visualization with near-infrared ray catheter using a medical imaging projection system in open colon cancer surgery

Abstract

Indocyanine green （ICG） fluorescence-guided surgery is widely used in gastroenterological procedures. The near-infrared ray catheter （NIRC） is a novel ureteral catheter used for laparoscopic pelvic surgery. However, the use of NIRC for fluorescent ureteral visualization in open surgery has not been described. The Medical Imaging Projection System （MIPS） was developed for real-time fluorescent observation during open surgery. We report the first case of ureteral visualization during open colon cancer surgery using NIRC with MIPS. An 87-year-old female was diagnosed with advanced cecal cancer using abdominal computed tomography and colonoscopy. The cancer extended from the terminal ileum to the cecum. The NIRC was inserted preoperatively, and open ileocolic resection was performed safely without ureteral injury. NIRC with MIPS facilitated real-time ureteral visualization. The patient had an uneventful postoperative course and was discharged on postoperative day 12. Real-time intraoperative ureteral visualization with NIRC using MIPS may aid in visualizing the urinary tract and preventing ureteral injury during open colorectal surgery. This technique represents a promising approach to enhancing safety during open surgical procedures.