Video-fluorescence navigation by PpIX and tissue saturation measurement during surgical resection of gastric malignant tumor

Abstract

SignificanceThe quality of the anastomosis is an important factor influencing the outcome of the surgical operation. Since it provides a reliable connection of sutured biological tissues, it is necessary to control the consistency of the anastomosis in order to prevent complications after the operation. Fluorescence diagnostics makes it possible to determine the localization of the tumor and residual pathological tumor tissues after resection by the intensity of the photosensitizer fluorescence accumulated in tissue, which can be missed during visual examination. ApproachFluorescence diagnostics was performed using a diode laser with a wavelength of 635 nm, which is at the absorption peak of the photosensitizer protoporphyrin 9 (PpIX). The assessment of the StO2 level was carried out spectroscopically using white broadband radiation. ResultsThe tissue blood supply was assessed. Patients with stomach resection underwent fluorescent diagnostics using PpIX. The localization of the tumor and pathological tumor sites after partial resection of the stomach was determined. The change in the level of StO2 at each stage of the operation was determined. ConclusionsFluorescent diagnostics using PpIX and joint determination of StO2 by diffuse scattering spectroscopy improved the quality of tumor resection and assessed the state of gastric tissue blood supply in real time.