PMC9398569_01
(
A
) Preoperative magnetic resonance imaging (MRI) showing the anorectal malformation (ARM) with a rectourethral prostatic fistula. (
B
) Micturating cystourethrogram (MCUG) demonstrating a rectourethral prostatic fistula with a maximum diameter of 2 mm.
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The rectal pouch terminated at the level of the tip of the coccyx just below the bladder base ( Fig. 1B ). 
Intraoperative indocyanine green (ICG) fluorescence. (
A1
,
A2
) Visible light images. (
B1
,
B2
) Near-infrared (NIR) images. (
B1
) Assessment of intestinal perfusion during the pull-through lengthening maneuvers was a valuable first step after disconnecting the rectourethral fistula. (
B2
) A second dose of ICG was injected to visualize the vascular perfusion of the intestine and perineal wound edges before the anoplasty.
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 Favorable fluorescence was obtained within 1 minute using the EleVision IR system (Medtronic Ltd, U.K.) ( Fig. 2 ).  After that, a second dose of ICG (1 mg, 0.2 mg/kg) was injected to visualize the vascular perfusion at the skin level and during the anoplasty ( Fig. 2 ).