Use of near infrared fluorescence during robot-assisted laparoscopic partial nephrectomy☆

Abstract Background Partial nephrectomy is the treatment of choice for T1a tumors. The open approach is still the standard method. Robot-assisted laparoscopic surgery offers advantages that are applicable to partial nephrectomy, such as the use of the Firefly ® system with near-infrared fluorescence. Objective To demonstrate the implementation of fluorescence in nephron-sparing surgery. Case report This case concerned a 37-year-old female smoker, with obesity. The patient had a right kidney tumor measuring 31 mm, which was found using tomography. She therefore underwent robot-assisted laparoscopic partial nephrectomy, with a warm ischemia time of 22 min and the use of fluorescence with the Firefly ® system to guide the resection. There were no complications. The tumor was a pT1aN0M0 renal cell carcinoma, with negative margins. Robot-assisted renal laparoscopic surgery is employed for nephron-sparing surgery, with good oncological and functional results. The combination of the Firefly ® technology and intraoperative ultrasound can more accurately delimit the extent of the lesion, increase the negative margins and decrease the ischemia time. Conclusion Near-infrared fluorescence in robot-assisted partial nephrectomy is useful for guiding the tumor resection and can potentially improve the oncological and functional results.