Intraoperative Thermal and Laser Speckle Contrast Imaging Assessment of Bowel Perfusion in Two Cases of Colorectal Resection Surgery

Abstract

The Microvascular Diagnostics Service at Freeman Hospital, Newcastle upon Tyne, holds a comprehensive range of optical and thermal technologies utilised to study the microcirculation both for clinical and research purposes. In the recent years, collaboration has been formed with the colorectal surgical service to look at the feasibility and clinical value of intraoperatively assessing bowel perfusion using microvascular imaging technologies. Anastomotic failure is the most serious complication following colorectal resection that can lead to re-operation, permanent stoma, and even death. The current practice of assessing blood perfusion at the anastomosis bowel ends by direct inspection of bowel pulsatility, bleeding, and tissue coloration has been demonstrated to lack predictive accuracy. The medical community is striving to improve the outcome of colorectal resections and a key aspect in achieving this goal will be the development of more objective techniques to intraoperatively assess and quantify the bowel perfusion. We believe that microvascular imaging technology could play a key role in this respect. In this chapter, we describe two case studies which show the feasibility of performing thermal and laser speckle contrast imaging measurements intraoperatively for assessing bowel perfusion during colorectal resection surgery. This experience could pave the way to a number of other applications for these technologies in the surgical arena.