Introduction & Objectives: Extended pelvic lymph node (LN) dissection (ePLND) is the standard nodal staging procedure for prostate cancer (PCa). Some metastatic LNs could be located out of the template area and might be missed during operation. Enlarging the template could decrease the rate of missed metastatic LNs while might increase the rate of morbidity. Sentinel lymph node dissection is not a routine procedure for PCa. The visualization of the lymphatics of the prostate by the near-infrared-fluorescence technology with indocyanine green (ICG) might detect the metastatic LNs that are located particularly out of the template area. The aim of the present study was to investigate whether visualization of the lymphatic drainage of the prostate with ICG usage contributes to ePLND in robotic PCa surgery.

Materials & Methods: Between April 2019-December 2020, 38 patients with prostate cancer underwent initial bilateral nerve sparing RARP with intraoperative frozen section by NeuroSAFE technique. 36 patients had preoperative multiparametric MRI and 23 had a prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT).Neurovascular bundles (NVBs) were resected in case of intraoperative positive surgical margin (PSM) at frozen section analysis.