MODERN APPROACHES TO FLUORESCENT DIAGNOSTICS AND NAVIGATION IN PAEDIATRIC SURGERY

Abstract

In paediatric urology, surgical precision is crucial, as even the slightest error can affect the functioning of the body and the quality of life of the child. Modern technologies open up new opportunities for safer and more effective treatment. Fluorescent imaging using indocyanine green (ICG) allows real-time assessment of tissue blood supply, determination of resection margins, and detection of vascular structures. This increases the accuracy and safety of interventions. The use of ICG-NIRF in paediatric surgery is an important step in the field of technological innovation. Research objective: to analyse current clinical data on the use of indocyanine green (ICG) fluorescence imaging in paediatric urology, determine its diagnostic and surgical potential, and evaluate the effectiveness of the method in improving the accuracy and safety of surgical interventions. Materials and methods: A review of current scientific literature was conducted using the PubMed, Scopus, Web of Science, and Google Scholar databases with the following keywords: ‘indocyanine green,’ ‘fluorescence imaging,’ ‘paediatric urology,’ ‘ICG-NIRF,’ and ‘robotic surgery.’ The study included clinical observations, prospective and retrospective case series highlighting the use of ICG- NIRF in various surgical procedures in paediatric urology, including robotic interventions. The analysis was conducted taking into account the effectiveness, safety and technical features of the operations. Survey results and discussion: Analysis of the literature showed that the use of ICG-NIRF significantly improves the visualisation of vascular and lymphatic structures, allowing the surgeon to accurately assess tissue perfusion in real time. This approach reduces the risk of ischaemic complications, facilitates organ-preserving surgery, and generally contributes to a reduction in postoperative complications. The use of fluorescent navigation is extremely useful in paediatric practice, where the anatomical features of children require maximum precision. Despite certain technical limitations (signal penetration depth, short fluorescence duration), the advantages of the method significantly outweigh the disadvantages, providing a new level of control and safety in surgical interventions. Conclusions: Fluorescent imaging with indocyanine green is an innovative tool that expands the possibilities of paediatric urology. It increases accuracy, minimises the risk of complications and promotes the development of minimally invasive surgery. Further improvement of the technology and standardization of its application protocols open up prospects for even safer and more effective treatment of children with various pathologies.