Introduction/Background Sentinel lymph node (SLN) mapping with indocyanine green is an accepted technique comparing to complete lymphadenectomy in endometrial cancer, reducing surgical morbidity, and securing information about lymph node status for treatment planning. However, the implementation of this technique in clinical practice requires appropriate means and, in our institution, is emerging as our desired standard-of-care.

Methodology We aimed to describe and analyse the surgical technique of SLN mapping with indocyanine green in a low-risk patient with endometrial cancer.

Results A fifity-four years old women, with BMI 30 and no other previous medical conditions, presented with a three-month history of post-menopausal bleeding. The ultrasound examination showed endometrial thickening of 23 mm. A diagnosis of endometrioid adenocarcinoma grade 1 was made and the magnetic resonance showed a myometrial invasion <50%. After the superficial and deep cervical injection of the indocyanine green, we inspected the abdominal cavity and identified the pelvic lymph pathways and pelvic sentinel lymph nodes. Through this technique, we could identify four sentinel lymph nodes (two on the left, one on the right and one in interiliac region). The procedure continued with total hysterectomy and bilateral salpingooforectomy, with good recovery and no complications. The histopathological examination revealed endometrioid adenocarcinoma, with good differentiation, with less than 1 mm invasion in the myometrium, without lymphovascular space invasion. The four lymph nodes were ultrastaged and were negative. The patient is now in clinical surveillance.

Conclusion This video highlights that sentinel lymph node mapping and detection with the indocyanine green technique is a feasible procedure and allows accurate and precise identification of all sentinel lymph nodes. In fact, this technique is currently starting as a routine practice in our institution and is now the preferred method given the main advantages that it offers, including improved sentinel lymph node detection rates and good patient acceptability and satisfaction.