Laparoscopic evaluation of intestinal ischemia using fluorescein and ultraviolet light in a porcine model

Background: The laparoscopic use of fluorescein and ultraviolet light may be a useful diagnostic tool that potentially could reduce the time until diagnosis and the subsequent mortality of mesenteric ischemia. Methods: Eight pigs were subjected to a pneumoperitoneum pressure of 7 mmHg, and another eight pigs were exposed to a pressure of 14 mmHg. A segment of small bowel was devascularized. Two filters were used to create ultraviolet light. Pigs from each pressure group were given various intravenous fluorescein doses. The ischemic segment of the small intestine and other structures were inspected laparoscopically with the filters attached. A videotape was evaluated by resident and attending surgeons. Results: Ischemic bowel was seen as a darkened silhouette against the viable fluorescent tissue. Overall, the results show that the use of ultraviolet light and fluorescence in the laparoscopic model is adequate for allowing the identification of ischemic bowel. Conclusions: The laparoscopic use of ultraviolet light combined with intravenous fluorescein dye is an effective diagnostic tool for evaluating mesenteric ischemia in pigs.