[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-458826-105":59,"doc-detail-458826-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","robotic-assisted-resection-of-parametrial-endometriosis-with-ureterolysis-of-a-medially-distorted-ureter-surgical-technique","Robotic-assisted resection of parametrial endometriosis with ureterolysis of a medially distorted ureter - Surgical Technique","","Deep infiltrating endometriosis (DIE) can invade multiple pelvic structures, with ureteral endometriosis (UE) representing the most challenging urinary tract involvement. Multidisciplinary surgery with hormonal therapy is central to DIE management. A 29-year-old nulliparous patient with severe dysmenorrhea and chronic pelvic pain underwent robotic-assisted resection of parametrial endometriosis and ureterolysis using retrograde indocyanine green injection and near-infrared fluorescence. Discharge occurred after 48 hours.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/robotic-assisted-resection-of-parametrial-endometriosis-with-ureterolysis-of-a-medially-distorted-ureter-surgical-technique/458826/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/robotic-assisted-resection-of-parametrial-endometriosis-with-ureterolysis-of-a-medially-distorted-ureter-surgical-technique/458826.png","ImageObject",300,407,{"name":92,"@type":93},"Alexandar","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-08","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":14},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What is the main surgical approach described in this case report?","Question",{"text":112,"@type":113},"The report describes robotic-assisted resection of parametrial endometriosis with ureterolysis, using near-infrared fluorescence guidance.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How is indocyanine green (ICG) used during the procedure?",{"text":117,"@type":113},"ICG is injected retrogradely into the ureter, enabling visualization of the ureter under near-infrared fluorescence.",{"name":119,"@type":110,"acceptedAnswer":120},"Why was ureterolysis considered careful in selected cases?",{"text":121,"@type":113},"The report states that ICG can be absorbed in the ureteral mucosa/wall even without leaving a temporary ureteral stent during surgery, supporting careful ureterolysis.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},458826,1790754541,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":14,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":81,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":129,"read_time":39,"preview_page_count":4},962090768658,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","Journal of Surgical Case Reports, 2026, 1, rjaf1064  \n[https://doi.org/10.1093/jscr/rjaf1064](https://doi.org/10.1093/jscr/rjaf1064)  \nSurgical Technique  \nSurgical Technique  \nRobotic-assisted resection of parametrial endometriosis with ureterolysis of a medially distorted ureter using indocyanine green and near-infrared fluorescence  \nPhilippe Van Trappen 1 , *, Gaby Moawad2 , Christophe Ghysel3 , Harm Arentsen3  \n1 Department of Gynecology and Gynecological Oncology, AZ Sint-Jan Hospital Bruges, Ruddershove 10, 8000 Bruges, Belgium  \n2 Department of Obstetrics and Gynecology, The George Washington University Hospital, 900 23rd St Nw, Washington, DC 20037-2342, United States  \n3 Department of Urology, AZ Sint-Jan Hospital Bruges, Ruddershove 10, 8000 Bruges, Belgium  \n*Corresponding author. Department of Gynecology and Gynecological Oncology, AZ Sint-Jan Bruges AV, Ruddershove 10, 8000 Bruges, Belgium . [E-mail:](E-mail: philippe.vantrappen@azsintjan.be)[ philippe.vantrappen@azsintjan.be](E-mail: philippe.vantrappen@azsintjan.be)  \nAbstract  \nDeep infiltrating endometriosis (DIE) is a severe form of endometriosis, with endometriotic implants that can invade several anatomical structures. The urinary tract is the second most common site for deep endometriosis with ureteral endometriosis (UE) the most challenging to manage. Multidisciplinary surgery along with hormonal therapy is the corner stone for the treatment of DIE. Here we describe, with a video, a surgical technique using robotic-assisted surgery along with retrograde injection of indocyanine green (ICG) in the ureter for resection of parametrial endometriosis and ureterolysis using near-infrared fluorescence. The case was a 29-year-old nullipara with a history of severe dysmenorrhea and chronic pelvic pain. The patient was discharged after 48 hrs. The advantages of robotic surgery and the use of ICG in the ureter, in selected cases with UE, enables careful ureterolysis as ICG can even be absorbed in the ureteral mucosa/wall when no stent is left behind during surgery.  \nKeywords: endometriosis; ICG; infrared fluorescence; parametrium; robotic; ureter  \nIntroduction  \nEndometriosis is a chronic medical condition, affecting approximately 10% of women in their reproductive age, with the extra-uterine presence of ectopic implants of endometrial-like glands/stromal tissue [1] . The urinary tract represents the second most common site for deep infiltrating endometriosis (DIE) with ureteral endometriosis (UE) having a prevalence up to 23%, affecting mostly the distal ureter in the parametrium [2] . UE can be subdivided into intrinsic and extrinsic forms. Intrinsic UE involves endometriosis and/or fibrosis in either the muscular or uroepithelial layer, whereas extrinsic UE is characterized by the endometriotic invasion of the ureteric adventitia or more often the nearby connective tissue of the parametrium, which may lead to compression or distortion of the ureter [3] . Because of the often difficult challenge to perform successfully ureterolysis incase of extensive DIE in the pelvis, indocyanine green (ICG) was introduced to visualize the ureter with this fluorescent tracer in near-infrared (NIR) light [1 , 4–6] .  \nCase report  \nA 29-year-old G1P0A1 with a history of severe dysmenorrhea and chronic pelvic pain was referred to our tertiary center for surgery,  \nafter being diagnosed with DIE in the right parametrium and encasing the right ureter on ultrasonography. Further preoperative imaging with magnetic resonance imaging (MRI) revealed DIE on the posterior wall of the cervix with several T2 hypointense small cysts (with protein rich content), extending to the torus uterinus and to thickened right uterosacral ligament; the right ureter was dilated (hydroureter) and medially distorted by a T2-hypointense cordly-shaped zone in the right parametrium (Fig. 1) . The endometriosis in the right antero-lateral parametrium was encasing the right distal ureter (Fig. 1); there was e","cbCaitQUwcGvcUsw","https://ap.wps.com/l/cbCaitQUwcGvcUsw","pdf",532817,"English","# Abstract\n# Introduction\n# Case report","[{\"question\":\"What is the main surgical approach described in this case report?\",\"answer\":\"The report describes robotic-assisted resection of parametrial endometriosis with ureterolysis, using near-infrared fluorescence guidance.\"},{\"question\":\"How is indocyanine green (ICG) used during the procedure?\",\"answer\":\"ICG is injected retrogradely into the ureter, enabling visualization of the ureter under near-infrared fluorescence.\"},{\"question\":\"Why was ureterolysis considered careful in selected cases?\",\"answer\":\"The report states that ICG can be absorbed in the ureteral mucosa/wall even without leaving a temporary ureteral stent during surgery, supporting careful ureterolysis.\"}]","Robotic-assisted resection of parametrial endometriosis with ureterolysis of a medially distorted ureter - Surgical Technique | PDF"]