Abstract
Intraoperative monitoring of tissue oxygen saturation (StO2 ) has potentially important applications in procedures such as organ transplantation or colorectal surgery, where successful reperfusion affects the viability and integrity of repaired tissues. In this paper a liquid crystal tuneable filter-based multispectral imaging (MSI) laparoscope is described. Motion-induced image misalignments are reduced, using feature-based registration, before regression of the tissue reflectance spectra to calculate relative quantities of oxy- and deoxyhaemoglobin. The laparoscope was validated in vivo, during porcine abdominal surgery, by making parallel MSI and blood gas measurements of the small bowel vasculature. Ischaemic conditions were induced by local occlusion of the mesenteric arcade and monitored using the system. The MSI laparoscope was capable of measuring StO2 over a wide range (30-100%) with a temporal error of ± 7.5%. The imager showed sensitivity to spatial changes in StO2 during dynamic local occlusions, as well as tracking the recovery of tissues post-occlusion.
Highlights
The blood supply to a surgically-treated organ is the key factor in determining how well it heals and whether or not normal function will be restored
Reperfusion of tissues following periods of ischaemia may result in damage to the parenchyma and the microcirculation in a condition known as ischemia-reperfusion injury [2]
It consists of a 30° laparoscope (Karl STORZ GmbH, Tuttlingen, Germany), liquid crystal tunable filter (LCTF; Varispec, CRi, Inc., USA), 50 mm focal length achromatic imaging lens (Thorlabs Ltd., UK)
Summary
The blood supply to a surgically-treated organ is the key factor in determining how well it heals and whether or not normal function will be restored. Insufficient perfusion of oxygenated blood can result in ischaemia [1] and subsequent damage to the tissue. Creation of an anastomosis (surgical attachment of two luminal structures) in the gastrointestinal (GI) tract to restore continuity following tumour resection is one such example. The local blood supply is compromised by the resection, meaning that selection and preparation of the tissue for anastomosis are important factors in ensuring the success of the procedure. Reperfusion of tissues following periods of ischaemia may result in damage to the parenchyma and the microcirculation in a condition known as ischemia-reperfusion injury [2]. Failure to choose adequately perfused tissues for anastomosis may result in dehiscence of the join and leakage of GI contents, resulting in severe complications for the patient [3] including death. Intraoperative decision-making in this regard is still typically based on subjective measures, such as the appearance (colour) of the tissue, and is dependent on the experience of the surgeon
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