Robotic Nephrectomy More Effective with Firefly Imaging Technology

May 30, 2012: Advanced Urology surgeons in Denver, Colorado are treating kidney cancer with less invasive procedures, and finding greater results, in part due to the addition of Firefly™ fluorescence during da Vinci® robotic surgery.

“Firefly fluorescence is an additional imaging system we now are using during robotic partial nephrectomy,” explains urologist and robotic surgeon Ali Sarram, M.D. “The system gives us a more detailed picture of kidney blood flow as well as clear distinction between cancerous and non-cancerous tissue. This additional information helps us spare more healthy kidney tissue, remove larger tumors with less invasion, and ensure proper kidney function.”

Robotic Nephrectomy and Firefly Fluorescence: A Three-Phase Process

Firefly fluorescence during robotic nephrectomy takes place in three phases. During each phase, surgeons inject a small amount of tracer dye called indocyanine green (ICG). Nearly infrared imaging tracks the green dye and the surgeon seated at the robotic console can switch between a traditional laparoscopic camera view and a view that tracks movement of the Firefly dye.

  1. 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 Dr. Sarram. “Firefly helps us see all of the arteries that feed the kidney, which helps reduce blood loss.”
  2. 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.
  3. 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.”

Kidney Mass Removal, Before Firefly Fluorescence
Kidney Mass Removal, Before Firefly Fluorescence
Kidney Mass Removal, After Firefly Fluorescence
Kidney Mass Removal, After Firefly Fluorescence

About Kidney Cancer

Kidney cancer affects an estimated 50,000 Americans each year. In its earliest stage, kidney cancer does not present any symptoms, but later stage patients may experience back or abdominal pain, dark colored urine, blood in urine and weight loss. Older males who have a history of smoking are at highest risk for kidney cancer.

To learn more about Firefly fluorescence technology or if you are a candidate for robotic kidney surgery, contact Advanced Urology>>