The ICG-Foley: A Novel Indocyanine Green-Coated Foley Catheter for Enhanced Anatomic Identification During Robot-Assisted Laparoscopic Prostatectomy

Abstract

Background: Precise identification of the bladder neck and urethra during robot-assisted laparoscopic prostatectomy (RALP) is critical for continence preservation but remains challenging, particularly during the Retzius-sparing approach. Objective: To describe a novel indocyanine green (ICG)-coated Foley catheter (ICG-Foley) that enhances intraoperative identification of the bladder neck and urethra during RALP and to report preliminary functional outcomes. Methods: A 16Fr latex Foley catheter was soaked in ICG–saline solution (25 mg/210 mL) for 3 minutes before placement. The technique was evaluated in 4 consecutive patients undergoing RALP using the da Vinci SP and Xi robotic platforms. Results: The ICG-Foley provided consistent near-infrared fluorescence throughout all procedures, enabling clear identification of the bladder neck and apical urethra. All 4 patients achieved continence (≤1 pad/day) by 12 months. Conclusions: The ICG-Foley is a simple, low-cost adjunct that enhances real-time anatomic identification during RALP and may serve as a valuable tool for both experienced surgeons and those early in their learning curve.