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| Name | 432 Utility of near infrared fluorescence imaging in robotic partial cystectomy- Karthik Thandapani |
| Video Uploader | Video From Vattikuti Foundation |
| Upload Date | This Video Uploaded At 17-01-2025 20:14:38 |
| Video Discription | This video is being presented at the Humans at the Cutting Edge of Robotic Surgery Symposium 2024, Jaipur, India. It was produced by Dr Karthik Thandapani, Lister Hispital , Stevenage, UK Abstract: Introduction: Primary adenocarcinoma of the bladder is a rare neoplasm, with sparse evidence on optimal management options. Bladder sparing partial cystectomy has been shown to have comparable long-term outcomes with radical cystectomy. Methods: One of the challenges with a robotic approach include recognition of adequate margin around the tumour. We demonstrate our technique of precise partial cystectomy, which utilizes near infrared fluorescence imaging (FireflyTM), in a 76 year old lady with T1 adenocarcinoma of urachal origin. Patient was counselled for a robot assisted laparoscopic partial cystectomy with enbloc urachal excision and bilateral pelvic lymphadenectomy. In lithotomy position under general anesthesia, a transurethral incision of adequate margin around the tumour is made using Collin’s knife. Patient is then repositioned similar to a radical cystectomy configuration, ports inserted and the robot docked. The space of Retzius is developed and bladder dropped. A flexible cystoscopy is introduced and guided to the margin incisions made prior. The cystoscope light is then recognized laparoscopically by switching to FireflyTM mode and accurate cystostomy performed. This step is especially crucial for the particular case presented as the tumour is non- contiguous with the urachus and present at the right anterolateral dome. The incised margin is traced and tumour excised completely. The urachus is removed enbloc. The bladder defect is closed watertight in 2 layers and leak test performed. A bilateral pelvic lymphadenectomy is performed. Results and conclusion: Surgical margins were negative, with a minimal margin of 1.6cm. Use of FireflyTM improves surgical precision and its reproducibility. See more at: http://vattikutifoundation.com/ |
| Category | Science & Technology |
| Tags | Robotic Surgery | Bladder Cancer |
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