Experimental evaluation of laparoscopic laser speckle contrast imaging to visualize perfusion deficits during intestinal surgery

Autor: Wido Heeman, Aurelia C. L. Wildeboer, Mahdi Al-Taher, Joost E. M. Calon, Laurents P. S. Stassen, Michele Diana, Joep P. M. Derikx, Gooitzen M. van Dam, E. Christiaan Boerma, Nicole D. Bouvy
Přispěvatelé: Pediatric surgery, Paediatric Surgery, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam Reproduction & Development (AR&D), Health & Food, ​Basic and Translational Research and Imaging Methodology Development in Groningen (BRIDGE), Microbes in Health and Disease (MHD), Guided Treatment in Optimal Selected Cancer Patients (GUTS), Surgery, MUMC+: MA AIOS Heelkunde (9), RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, MUMC+: MA Heelkunde (9), RS: NUTRIM - R2 - Liver and digestive health
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Surgical Endoscopy. Springer New York
Surgical endoscopy. Springer New York
Heeman, W, Wildeboer, A C L, Al-Taher, M, Calon, J E M, Stassen, L P S, Diana, M, Derikx, J P M, van Dam, G M, Boerma, E C & Bouvy, N D 2022, ' Experimental evaluation of laparoscopic laser speckle contrast imaging to visualize perfusion deficits during intestinal surgery ', Surgical Endoscopy . https://doi.org/10.1007/s00464-022-09536-9
Surgical endoscopy and other interventional techniques. SPRINGER
Surgical endoscopy and other interventional techniques. Springer, Cham
ISSN: 0930-2794
DOI: 10.1007/s00464-022-09536-9
Popis: Background Ischemia at the site of an intestinal anastomosis is one of the most important risk factors for anastomotic leakage (AL). Consequently, adequate intestinal microperfusion is essential for optimal tissue oxygenation and anastomotic healing. As visual inspection of tissue viability does not guarantee an adequate objective evaluation of intestinal microperfusion, surgeons are in dire need of supportive tools to decrease anastomotic leakage after colorectal surgery. Methods In this feasibility study, laparoscopic laser speckle contrast imaging (LSCI) was used to evaluate intestinal microperfusion in an experimental ischemic bowel loop model. Both large and small ischemic loops were created from the small intestine of a pig; each loop was divided into 5 regions of interest (ROI) with varying levels of ischemia. Speckle contrast and local capillary lactate (LCL) was measured in all ROIs. Results Both real-time visualization of intestinal microperfusion and induced perfusion deficits was achieved in all bowel loops. As a result, the emergence of regions of intestinal ischemia could be predicted directly after iatrogenic perfusion limitation, whereas without LSCI signs of decreased intestinal viability could only be seen after 30 minutes. Additionally, a significant relation was found between LCL and LSCI. Conclusion In conclusion, LSCI can achieve real-time intraoperative visualization of intestinal microperfusion deficits, allowing for accurate prediction of long-term postoperative ischemic complications. With this revealing capacity, LSCI could potentially facilitate surgical decision-making when constructing intestinal anastomoses in order to mitigate ischemia-related complications such as AL.
Databáze: OpenAIRE
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