RAISN: Robot-assisted Indocyanine Green–guided Sentinel Node Biopsy in Clinical Stage I Germ Cell Tumor

The RAISN trial is investigating the sensitivity of robot-assisted sentinel lymph node biopsy using free indocyanine green for detection of occult metastatic disease in patients with newly diagnosed testicular cancer. Robot-assisted imaging-guided sentinel lymph node biopsy is a novel technique that has not been widely investigated in testicular germ cell tumor (GCT). Current staging strategies have poor accuracy for prediction of occult metastatic disease in clinical stage I GCT. Feasibility studies have used 99mTc-nanocolloid staining during laparoscopic procedures. The RAISN trial is investigating robot-assisted lymph node resection guided by indocyanine green fluorescence imaging. This new diagnostic approach is potentially more precise and easier to apply, and is widely available. Confirmation of its utility could change the management of newly diagnosed GCT by reducing overtreatment and treatment-related toxicity.