Background and Aim: Pediatric surgery requires high precision and safety due to children's unique anatomy and physiology. Innovations that enhance surgical precision, reduce operative time, and improve postoperative outcomes are invaluable. Indocyanine green (ICG), a near‐infrared fluorescent dye, has received significant attention for its potential to address these needs. The study aimed to describe applications of ICH in pediatric surgery in Poland, provide evidence to support integration of ICG into pediatric surgical practice and evaluate the safety and feasibility of ICG.Methods: Data were collected from the medical records of 136 patients undergoing surgical treatment in four leading pediatric surgical clinical centers in Poland. There are four main groups of surgical procedures: oncological, gastrointestinal, urological and lymphatic. Calculations were performed using Statistica 13 by TIBCO and PQStat v. 1.8.6.120 by PQStat Software. Additionally, descriptive statistics were performed.Results: The efficacy and safety of ICG were confirmed in the entire study group. No complications were reported with the use of the indocyanine green. Exhaustive descriptive statistics presented key information on the use of ICG for each of the studied groups.Conclusions: The study validates the efficacy and safety of ICG fluorescence imaging in pediatric surgery. By enhancing surgical precision and improving postoperative outcomes, ICG represents a significant advancement in pediatric surgical care. The establishment of standardized protocols and the emphasis on specialized training will be key to maximizing the benefits of ICG.

Background: Congenital renal masses in neonates are most commonly congenital mesoblastic nephroma or, less frequently, or Wilms tumor. We describe a neonate with an apparent primary renal tumor that proved to be adrenal neuroblastoma infiltrating the kidney, highlighting diagnostic pitfalls in this subgroup of patients. Methods: We retrospectively reviewed the diagnostic work-up, histopathology, genomic profiling, treatment, and outcome of a term neonate in whom a renal mass was detected incidentally on ultrasound. Results: Ultrasound and MRI showed a 2 cm solid lesion centered in the upper pole of the left kidney, interpreted as nephroblastomatosis/early Wilms tumor. Left nephrectomy with adrenalectomy revealed stroma-poor, undifferentiated neuroblastoma with regional node involvement and multiple segmental chromosomal aberrations, including 1p and 3p loss, but no MYCN or ALK alterations. Initial management consisted of surgery alone with close surveillance. Within weeks, early disseminated relapse with bone and soft-tissue metastases occurred, necessitating escalation to high-risk, COJEC-based chemotherapy; resection of residual mass; and modified consolidation without high-dose chemotherapy or radiotherapy. The child remains in complete remission with preserved renal function. Conclusions: Neuroblastoma should be considered in the differential diagnosis of congenital “renal” masses. Imaging-driven provisional diagnoses may be misleading, and genomic risk profiling may help lower the threshold for systemic therapy in selected cases.