Successful Robot‐Assisted Resection of a Retroperitoneal Cystic Tumor With Fluorescent Ureteral Stent and Firefly Imaging

Introduction We present a technique that combines a fluorescent ureteral catheter with Firefly near‐infrared fluorescence imaging to identify the ureter and avoid injury during robot‐assisted resection of a retroperitoneal cystic tumor. Case Presentation Computed tomography revealed a 6‐cm retroperitoneal cystic mass anterior to the abdominal aorta near the lower pole of the left kidney that adhered to the left ureter in a 53‐year‐old man. A fluorescent ureteral catheter was placed preoperatively, and robot‐assisted transperitoneal resection was performed. Firefly imaging enabled clear visualization of the ureter, allowing safe dissection and tumor identification. The tumor was excised without cyst rupture. The console time was 4 h 13 min, with minimal blood loss. Pathology confirmed schwannoma. Conclusion We demonstrated the feasibility and clinical benefits of integrating a fluorescent ureteral catheter with Firefly fluorescence imaging for intraoperative ureteral identification during robot‐assisted surgery. This fluorescence‐guided approach improves dissection accuracy and helps prevent ureteral injury.