目的：探讨膀胱镜下注射吲哚箐绿（ICG）指引腹膜外途径腹腔镜膀胱憩室切除术的临床疗效及安全性。方法：对3例BPH所致膀胱憩室患者行膀胱镜下注射ICG指引经腹膜外途径腹腔镜膀胱憩室切除术,憩室直径为85~135 mm。首先取截石位行经尿道膀胱镜检查找到憩室及颈口位置,使用内镜注射针于憩室底部黏膜下注射吲哚菁绿指示定位,然后在耻骨联合上方建立腹膜外间隙,找到标记的憩室,完整切除、缝合憩室颈口。结果：3例手术均顺利完成,无中转开放手术。手术时间130~180 min,术中出血20~50 mL。术中未出现周围脏器损伤,术后均未出现尿外渗。术后引流管拔除时间2~3 d,术后留置尿管7~12 d,术后住院7~14 d。随访3~10个月,均无复发,排尿症状较前明显改善。结论：膀胱镜下注射ICG指引腹膜外途径腹腔镜膀胱憩室切除术,术中可精准定位憩室位置,经腹膜外途径可以减少手术副损伤,使腹腔镜膀胱憩室切除术更精准、安全。

Objective： To explore the clinical efficacy and safety of laparoscopic extraperitoneal bladder diverticulectomy guided by injection of indocyanine green under with cystoscope.Methods： There were3 cases of bladder diverticulum caused by benign prostatic hyperplasia, aged 65 to 72 years, who underwent extraperitoneal laparoscopic bladder diverticulectomy guided by injection of indocyanine green under cystoscope. The maximum diameter of the diverticulum was 85-135 mm. The extraperitoneal space was established, the diverticulum was excised, and the diverticulum calyx wall was sutured.Results： All 3 operations were successfully completed, and no patients converted to open surgery. The operation time was 130-180 min, and the intraoperative blood loss was 20 to 50 mL. There was no peripheral organ injury during the operation. The pelvic drainage tube removal time was 2 to 3 days after operation, the catheter was withdrawn on the 7-12th postoperative day with no leakage of urine, and the hospital stay was 7 to 14 days after operation. During the follow-up period of 3 to 10 months, 3 patients had no recurrence, and urination symptoms were significantly improved.Conclusion： In extraperitoneal laparoscopic bladder diverticulectomy guided by injection of indocyanine green under cystoscope, indocyanine green can be used for accurate positioning, andthe extraperitoneal approach had less trauma, which makes the extraperitoneal laparoscopic bladder diverticulectomy safer and more accurate.