Hyperspectral imaging of gastrointestinal anastomoses
- 1 September 2018
- journal article
- research article
- Published by Springer Science and Business Media LLC in Der Chirurg
- Vol. 89 (9), 717-725
- https://doi.org/10.1007/s00104-018-0633-2
Abstract
Anastomotic insufficiency (AI) remains the most feared surgical complication in gastrointestinal surgery, which is closely associated with a prolonged inpatient hospital stay and significant postoperative mortality. Hyperspectral imaging (HSI) is a relatively new medical imaging procedure which has proven to be promising in tissue identification as well as in the analysis of tissue oxygenation and water content. Until now, no data exist on the in vivo HSI analysis of gastrointestinal anastomoses. Intraoperative images were obtained using the TIVITA (TM) tissue system HSI camera from Diaspective Vision GmbH (Pepelow, Germany). In 47 patients who underwent gastrointestinal surgery with esophageal, gastric, pancreatic, small bowel or colorectal anastomoses, 97 assessable recordings were generated. Parameters obtained at the sites of the anastomoses included tissue oxygenation (StO(2)), the tissue hemoglobin index (THI), near-infrared (NIR) perfusion index, and tissue water index (TWI). Obtaining and analyzing the intraoperative images with this non-invasive imaging system proved practicable and delivered good results on a consistent basis. A NIR gradient along and across the anastomosis was observed and, furthermore, analysis of the tissue water and oxygenation content showed specific changes at the site of anastomosis. The HSI method provides a non-contact, non-invasive, intraoperative imaging procedure without the use of a contrast medium, which enables a real-time analysis of physiological anastomotic parameters, which may contribute to determine the "ideal" anastomotic region. In light of this, the establishment of this methodology in the field of visceral surgery, enabling the generation of normal or cut off values for different gastrointestinal anastomotic types, is an obvious necessity.Keywords
This publication has 47 references indexed in Scilit:
- Multi-spectral video endoscopy system for the detection of cancerous tissuePattern Recognition Letters, 2013
- Hyperspectral imaging for early detection of oxygenation and perfusion changes in irradiated skinJournal of Biomedical Optics, 2012
- Managing Intraoperative Blood Pressure with NorepinephrineAnesthesiology, 2011
- Cancer detection using infrared hyperspectral imagingCancer Science, 2011
- Intraoperative laser fluorescence angiography in colorectal surgery: a noninvasive analysis to reduce the rate of anastomotic leakageLangenbecks Archives Of Surgery, 2010
- Tissue hemoglobin index: a non-invasive optical measure of total tissue hemoglobinCritical Care, 2009
- A New Diagnostic Algorithm for Early Prediction of Vascular Compromise in 208 Microsurgical Flaps Using Tissue Oxygen Saturation MeasurementsAnnals of Plastic Surgery, 2009
- Colonic Anastomotic Leak: Risk Factors, Diagnosis, and TreatmentJournal of the American College of Surgeons, 2009
- Surgeons lack predictive accuracy for anastomotic leakage in gastrointestinal surgeryInternational Journal of Colorectal Disease, 2009
- Characterization of a Near-Infrared Laparoscopic Hyperspectral Imaging System for Minimally Invasive SurgeryAnalytical Chemistry, 2007