TY  - EJOU
AU  - Rocco, Bernardo 
AU  - Totaro, Angelo 
AU  - Assumma, Simone 
AU  - Panio, Enrico 
AU  - Gavi, Filippo 
AU  - Presutti, Simona 
AU  - Russo, Pierluigi 
AU  - Panico, Giovanni 
AU  - Turri, Filippo 
AU  - Foschi, Nazario 
AU  - Fagotti, Anna 
AU  - Sighinolfi, Maria Chiara 

TI  - ICG-guided intracorporeal intestinal diversion with the Hugo™ RAS system following radical cystectomy: technological background and case report
T2  - Canadian Journal of Urology

PY  - 
VL  - 
IS  - 
SN  - 1488-5581

AB  - <b>Background:</b> Robotic radical cystectomy has demonstrated non-inferiority compared with the open approach; however, bowel and uretero-enteric anastomoses remain challenging and prone to complications. Indocyanine Green (ICG) is a fluorescent dye that emits near-infrared light after intravenous administration and enhances the evaluation of tissue perfusion, lymphatic mapping, and anatomical delineation. By allowing real-time assessment of tissue viability, ICG may reduce the risk of anastomotic leakage and ischemic complications. ICG fluorescence was first integrated into the Da Vinci system through Firefly technology, while the Hugo™ Robotic-Assisted Surgery (RAS) platform initially lacked ICG compatibility. We report a preliminary urological application of the recently developed Rubina® ICG fluorescence system integrated with Hugo™ RAS for intracorporeal intestinal diversion following radical cystectomy.<br/>

<b>Case Description:</b> A 72-year-old male patient with a BMI of 32 was eligible for robotic-assisted radical cystectomy with intracorporeal ileal conduit using the Hugo™ RAS platform. Rubina® with ICG was employed to assess real-time perfusion of the mesentery, ureters, and anastomosis, confirming adequate vascularization. The combined use of Rubina® on Hugo™ provided clear and versatile imaging, potentially reducing anastomotic complications. Postoperative recovery was uneventful, with no complications or readmissions, and normal renal function was observed at 4 months follow-up.<br/>

<b>Conclusions:</b> This case represents a successful use of the Rubina® ICG fluorescence system integrated with Hugo™ RAS for intracorporeal intestinal diversion after radical cystectomy. ICG fluorescence enables real-time perfusion assessment, potentially reducing anastomotic complications. This experience expands the capabilities of the Hugo™ platform and supports the role of fluorescence-guided robotic surgery in complex urologic procedures.
KW  - bladder cancer
KW  -  robotic surgery
KW  -  radical cystectomy
KW  -  robotic systems
KW  -  case report

DO  - 10.32604/cju.2026.067267