Indocyanine green fluorescence navigation in robot-assisted radical prostatectomy: a literature review

The aim of the study is to analyze current evidence on the use of fluorescence-guided navigation with indocyanine green (ICG) during robot-assisted radical prostatectomy (RARP) and to assess its impact on surgical accuracy and patient safety.

Materials and methods. A literature review was conducted using the PubMed, Scopus, and Web of Science databases for the period 2010–2025. The search included the following key terms: indocyanine green, ICG, radical prostatectomy, robot-assisted prostatectomy, lymphadenectomy, fluorescence-guided surgery. Systematic reviews, prospective, and retrospective studies evaluating the application of ICG in RARP were analyzed.

Results. The use of ICG during RARP improves intraoperative visualization of lymph nodes, neurovascular bundles, and the dorsal venous complex, thereby enhancing the accuracy of lymphadenectomy and reducing the risk of injury to critical anatomical structures. Most studies demonstrate that ICG application shortens operative time, decreases blood loss, and increases the rate of nerve-sparing procedures without raising the incidence of positive surgical margins. However, standardization of the ICG dosage and administration protocol remains lacking, and further large-scale randomized trials are required to confirm its efficacy and reproducibility.

Conclusion. Fluorescence-guided surgery using indocyanine green represents a promising approach for intraoperative visualization during RARP, improving the precision and safety of surgical interventions. Further research is needed to optimize administration protocols and validate the method through multicenter clinical trials with high levels of evidence.

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