荧光引导手术 (FGS) 通过近红外 (NIR) 荧光染料的组织和疾病特异性对比，有望通过改变手术医学。临床开放和腹腔镜 FGS 视觉系统几乎完全在 NIR 波长下操作。然而，与临床可用的成像系统兼容的组织特异性 NIR 对比剂缺乏，因此在前列腺切除术中持续存在神经组织识别的挑战。在这里，我们展示了结合类似药物的分子设计概念和荧光染料化学，使得生产出一系列 NIR 苯鍛基荧光染料，用于术中神经特异性成像。候选物能在犬和猪模型中使用临床广泛应用于微创前列腺切除术的达芬奇手术系统，准确描述前列腺神经和髂丛。这些结果表明，通过分子工程在 NIR 神经结合荧光染料中的可行性，可以便利地集成到现有手术工作流程中，为前列腺癌患者减少神经损伤的发生铺平了道路。本文受版权保护，版权所有。

Fluorescence-guided surgery (FGS) is poised to revolutionize surgical medicine through near-infrared (NIR) fluorophores for tissue- and disease-specific contrast. Clinical open and laparoscopic FGS vision systems operate nearly exclusively at NIR wavelengths. However, tissue-specific NIR contrast agents compatible with clinically available imaging systems are lacking, leaving nerve tissue identification during prostatectomy a persistent challenge. Here, we show that combining drug-like molecular design concepts and fluorophore chemistry enabled the production of a library of NIR phenoxazine-based fluorophores for intraoperative nerve-specific imaging. The lead candidate readily delineated prostatic nerves in the canine and iliac plexus in the swine models using the clinical da Vinci Surgical System that has been popularized for minimally invasive prostatectomy procedures. These results demonstrate the feasibility of molecular engineering of NIR nerve-binding fluorophores for ready integration into the existing surigical workflow, paving the path for clinical translation to reduce morbidity from nerve injury for prostate cancer patients. This article is protected by copyright. All rights reserved.This article is protected by copyright. All rights reserved.