944 NEAR INFRARED TISSUE OXIMETRY AND DIGITAL IMAGE ANALYSIS: QUANTITATION OF RENAL ISCHEMIA IN REAL TIME DURING PARTIAL NEPHRECTOMY

Abstract

You have accessJournal of UrologyTechnology & Instruments: Robotics/Laparoscopy1 Apr 2011944 NEAR INFRARED TISSUE OXIMETRY AND DIGITAL IMAGE ANALYSIS: QUANTITATION OF RENAL ISCHEMIA IN REAL TIME DURING PARTIAL NEPHRECTOMY Arthur Caire, Xavier Alvarez, Sarah Conley, Alton Sartor, and Benjamin Lee Arthur CaireArthur Caire New Orleans, LA More articles by this author , Xavier AlvarezXavier Alvarez New Orleans, LA More articles by this author , Sarah ConleySarah Conley New Orleans, LA More articles by this author , Alton SartorAlton Sartor New Orleans, LA More articles by this author , and Benjamin LeeBenjamin Lee New Orleans, LA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.862AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Assessment of renal function recovery following hilar clamping during partial nephrectomy is currently performed indirectly, with no quantitative assays for real time measurement. Our Goal was to determine the feasibility of near infrared tissue oximetry (TO) and didgital image analysis and quantify local renal ischemia in a porcine model. METHODS TO and red/blue (R/B) color ratios were measured on renal units of Yorkshire swine. Interval measurements were prior to clamping the renal hilum, during warm ischemia, and after unclamping using the ViOptix T.Ox™ Tissue Oximeter as well as Matlab® digital image analysis. Matlab software analyzed images from the laparoscopic camera and determined an R/B ratio to track renal ischemia. The Tissue Oximeter measured tissue oximetry by direct infrared light and was placed adjacent to kidney parenchymal surface. The data was divided into preclamp, clamp, and post clamp and compared between methodologies. RESULTS The R/B of change demonstrated a larger rate of change compared to TO during clamp time in the 15 minute experiment (R/B=96.0 vs. TO=52.1 unit/reference) as well as the 30 minute experiment (R/B=97.6 vs. TO=45.9). The R/B ratio of change demonstrated a larger rate of change compared to TO at 1 minute post clamp time in the 15 minute experiment (R/B=80.1 vs. TO=12.4). Both detection devices had similar change in pre and post clamp measurements in the 15 minute experiment (R/B=1.6 vs. TO=3.8) and the 30 minute experiment (R/B=4.7 vs. TO=–4.5). In the 30 minute experiment the R/B ratio showed a significant difference between preclamp, clamp, and post clamp states (p=0.26). CONCLUSIONS Both Tissue oximetry and digital image analysis were able to calculate an ischemic drop in tissue oxygen saturation during periods of acute renal ischemia. The findings suggest that the R/B ratio demonstrated during histogram analysis shows a greater sensitivity in quantitating renal ischemia. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e379 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Arthur Caire New Orleans, LA More articles by this author Xavier Alvarez New Orleans, LA More articles by this author Sarah Conley New Orleans, LA More articles by this author Alton Sartor New Orleans, LA More articles by this author Benjamin Lee New Orleans, LA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...