Near-infrared fluorescence imaging for ureteral and sentinel lymph node mapping in gynecological minimally invasive surgery: a review of fluorophores and domestic laparoscopic systems

As laparoscopic techniques continue to advance, intraoperative tissue visualization has become increasingly important. In gynecological oncology, sentinel lymph node (SLN) mapping remains a critical procedure for assessing lymph node metastasis and guiding lymphadenectomy. Meanwhile, iatrogenic ureteral injury, although rare, can have severe consequences. Thus, achieving rapid, reliable, and cost-effective intraoperative visualization of both SLNs and the ureters during laparoscopy poses a significant clinical challenge. Near-infrared fluorescence (NIRF) imaging has emerged as a promising solution, using various fluorophores such as methylene blue (MB), indocyanine green (ICG), and technetium-99m ( 99m Tc) to enable clear visualization of living tissues. However, a comprehensive summary of the advantages and limitations of these fluorophores is lacking. This article reviews the efficacy of different fluorophores for SLN and ureteral mapping and discusses recent advances in domestic fluorescence laparoscopic systems.