Real-time quantification of bowel perfusion using Laparoscopic Laser Speckle Contrast Imaging (LSCI) in a porcine model

BMC Surgery

Research

Roman Stolyarov¹  Vasiliy E. Buharin¹  Chibueze A. Nwaiwu²  Yao Z. Liu²  Peter C. W. Kim²  Matthew F. Kalady³  Steven D. Schwaitzberg⁴  Saloni Mehrotra⁵ 

[1] Activ Surgical Inc., Boston, MA, USA;Activ Surgical Inc., Boston, MA, USA;Department of Surgery, Brown University, Providence, Rhode Island, USA;Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA;Department of Surgery, University at Buffalo, Buffalo, NY, USA;Department of Surgery, University at Buffalo, Buffalo, NY, USA;Activ Surgical Inc., Boston, MA, USA;

关键词: Bowel perfusion;    Laser speckle contrast imaging;    Perfusion quantification;    Anastomotic leak;    Indocyanine green;   

DOI  :  10.1186/s12893-023-02161-w

 received in 2023-03-31, accepted in 2023-08-19,  发布年份 2023

来源: Springer

【 摘 要 】

Background/purposeReal-time quantification of tissue perfusion can improve intraoperative surgical decision making. Here we demonstrate the utility of Laser Speckle Contrast Imaging as an intra-operative tool that quantifies real-time regional differences in intestinal perfusion and distinguishes ischemic changes resulting from arterial/venous obstruction.MethodsPorcine models (n = 3) consisted of selectively devascularized small bowel loops that were used to measure the perfusion responses under conditions of control/no vascular occlusion, arterial inflow occlusion, and venous outflow occlusion using laser speckle imaging and indocyanine green fluoroscopy. Laser Speckle was also used to assess perfusion differences between small bowel antimesenteric-antimesenteric and mesenteric-mesenteric anastomoses. Perfusion quantification was measured in relative perfusion units calculated from the laser speckle perfusion heatmap.ResultsLaser Speckle distinguished between visually identified perfused, watershed, and ischemic intestinal segments with both color heatmap and quantification (p < .00001). It detected a continuous gradient of relative intestinal perfusion as a function of distance from the stapled ischemic bowel edge. Strong positive linear correlation between relative perfusion units and changes in mean arterial pressure resulting from both arterial (R2 = .96/.79) and venous pressure changes (R2 = .86/.96) was observed. Furthermore, Laser Speckle showed that the antimesenteric anastomosis had a higher perfusion than mesenteric anastomosis (p < 0.01).ConclusionsLaser Speckle Contrast Imaging provides objective, quantifiable tissue perfusion information in both color heatmap and relative numerical units. Laser Speckle can detect spatial/temporal differences in perfusion between antimesenteric and mesenteric borders of a bowel segment and precisely detect perfusion changes induced by progressive arterial/venous occlusions in real-time.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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