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23-10-2023 | Minimally Invasive Surgery | New Technology

Intra-abdominal laparoscopic assessment of organs perfusion using imaging photoplethysmography

Authors: Victor A. Kashchenko, Alexander V. Lodygin, Konstantin Yu. Krasnoselsky, Valeriy V. Zaytsev, Alexei A. Kamshilin

Published in: Surgical Endoscopy | Issue 11/2023

Abstract

Background

An objective evaluation of the functional state and viability of biological tissues during minimally invasive surgery remains unsolved task. Various non-contact methods for evaluating perfusion during laparoscopic surgery are discussed in the literature, but so far there have been no reports of their use in clinical settings.

Methods and patients

Imaging photoplethysmography (iPPG) is a new method for quantitative assessment of perfusion distribution along the tissue. This is the first study in which we demonstrate successful use of iPPG to assess perfusion of organs during laparoscopic surgery in an operation theater. We used a standard rigid laparoscope connected to a standard digital monochrome camera, and abdominal organs were illuminated by green light. A distinctive feature is the synchronous recording of video frames and electrocardiogram with subsequent correlation data processing. During the laparoscopically assisted surgeries in nine cancer patients, the gradient of perfusion of the affected organs was evaluated. In particular, measurements were carried out before preparing a part of the intestine or stomach for resection, after anastomosis, or during physiological tests.

Results

The spatial distribution of perfusion and its changes over time were successfully measured in all surgical cases. In particular, perfusion gradient of an intestine before resection was visualized and quantified by our iPPG laparoscope in all respective cases. It was also demonstrated that systemic administration of norepinephrine leads to a sharper gradient between well and poorly perfused areas of the colon. In four surgical cases, we have shown capability of the laparoscopic iPPG system for intra-abdominal assessment of perfusion in the anastomosed organs. Moreover, good repeatability of continuous long-term measurements of tissue perfusion inside the abdominal cavity was experimentally demonstrated.

Conclusion

Our study carried out in real clinical settings has shown that iPPG laparoscope is feasible for intra-abdominal visualization and quantitative assessment of perfusion distribution.

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Title: Intra-abdominal laparoscopic assessment of organs perfusion using imaging photoplethysmography
Authors: Victor A. Kashchenko
Alexander V. Lodygin
Konstantin Yu. Krasnoselsky
Valeriy V. Zaytsev
Alexei A. Kamshilin
Publication date: 23-10-2023
Publisher: Springer US
Keyword: Minimally Invasive Surgery
Published in: Surgical Endoscopy / Issue 11/2023
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-023-10506-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Intra-abdominal laparoscopic assessment of organs perfusion using imaging photoplethysmography

Abstract

Background

Methods and patients

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods and patients

Results

Conclusion

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