Chapter 6 Abstract Background Ureteral injury during laparoscopic colorectal surgery is a rare but serious complication with reported incidence rates of 0.66%. The early detection and prevention of ureteral injury is clinically relevant and important. The successful use of pre‐clinical near‐infrared 78 (NIR) fluorophore CW800‐CA for real‐time intraoperative identification of the anatomical course of the ureters using a laparoscopic fluorescence imaging system is reported. Methods The usefulness of this new imaging technique was explored in two 35 kg pigs. Intravenous CW800‐CA was administered 10 minutes before conducting fluorescence imaging, using a commercially available laparoscopic fluorescence imaging system. Results A dose of 1 mg/ml CW800‐CA (bolus injection of 3 ml) provided clear delineation of the course of both ureters by using fluorescence mode of the laparoscope. There were no adverse reactions to the injected dye. Conclusion Near‐infrared fluorescence laparoscopy of the ureters, following intravenous CW800‐ CA administration, is easily applicable and provides real‐time identification of the course of the ureters.
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