Night vision technology is not just for the military. We also use it in robotic surgery in the battle against disease. Many robotic surgical systems are equipped with “firefly” technology. This typically involves an intravenous injection of an immunofluorescent dye. Moments later, your surgeon can switch their camera light from white to near-infrared (similar to night vision goggles). This dye will light up different structures based on their degree of vascularity. This can help your surgeon identify blood vessels, some tumors, and the blood flow to certain organs. Identifying this blood flow can be particularly useful during bowel, kidney, and other reconstructive procedures.
Firefly technology also has a few tricks up its sleeve. My favorite trick is identifying the ureters; those very thin tubes that drain the urine from the kidneys to the bladder. Since these delicate tubes traverse such a long course, they are subject to injury during robotic bowel and gynecologic surgery. In the case of identifying the ureters, the immunofluorescent dye is instilled directly into the lumen of the ureters via a small telescope placed through the urethra into the bladder. The ureters will then remain visible when your surgeon toggles to near-infrared light during the remainder of the procedure. In addition, any diseased portion of the ureter will not absorb the dye, thereby allowing your surgeon to visualize parts of the ureter that would require removal during a ureteral reconstructive surgery.
I never cease to be amazed by the advanced tools that continue to be added to our surgical toolbox. I imagine that we will soon be able to label our patient’s surgical anatomy as if we were reading a textbook!