Firefly™ Fluorescence during Robotic Nephrectomy
Sky Ridge Medical Center kidney surgeons use Firefly™ fluorescence during da Vinci® robotic surgery for partial nephrectomy (kidney removal). This additional imaging system offers:
- A more detailed picture of kidney blood flow
- A more clear distinction between cancerous and non-cancerous tissue
With this information, surgeons can spare more healthy kidney tissue, remove larger tumors with less invasion, and ensure proper kidney function.
How Firefly Fluorescence Works
There are three phases to Firefly fluorescence during robotic nephrectomy. Each phase begins with the surgeon injecting a small amount of indocyanine green (ICG), a tracer dye. Next, the green dye is tracked with nearly infrared imaging. The surgeon in control of the da Vinci robotic system can view both a traditional laparoscopic camera view and a view that tracks the Firefly dye movement.
- The first injection takes place at the start of the surgery to help visualize the kidney's blood supply. "Often smaller renal arteries are not clearly shown on CT or MRI," explains Ali Sarram. M.D., a urologist and robotic surgeon. "Firefly helps us see all of the arteries that feed the kidney, which helps reduce blood loss."
- The next injection allows the surgeon to clearly see the difference between cancerous and healthy tissue. This helps the surgeon leave less cancerous tissue behind and spare more healthy tissue.
- The final injection takes place after the tumor has been removed and the kidney has been repaired. This injection allows the surgeon to see restored blood flow to the kidney.
"Previously, we were not able to immediately see if the kidney was functioning properly," Dr. Sarram says. "With Firefly, we can check the blood flow and see that we are leaving it in the best shape possible."
After Firefly Imaging
Before Firefly Imaging