Visual discrimination of tissue during surgery can be challenging since different tissues appear similar to the human eye. Hyperspectral imaging (HSI) removes this limitation by associating each pixel with high-dimensional spectral information. While previous work has shown its general potential to discriminate tissue, clinical translation has been limited due to the method’s current lack of robustness and generalizability. Specifically, it had been unknown whether variability in spectral reflectance is primarily explained by tissue type rather than the recorded individual or specific acquisition conditions. The contribution of this work is threefold: (1) Based on an annotated medical HSI data set (9,059 images from 46 pigs), we present a tissue atlas featuring spectral fingerprints of 20 different porcine organs and tissue types. (2) Using the principle of mixed model analysis, we show that the greatest source of variability related to HSI images is the organ under observation. (3) We show that HSI-based fully-automatic tissue differentiation of 20 organ classes with deep neural networks is possible with high accuracy (> 95 %). We conclude from our study that automatic tissue discrimination based on HSI data is feasible and could thus aid in intraoperative decision making and pave the way for context-aware computer-assisted surgery systems and autonomous robotics.

Objective: To optimize anastomotic technique and gastric conduit perfusion with hyperspectral imaging (HSI) for total minimally invasive esophagectomy (MIE) with linear stapled anastomosis. Summary Background Data: Esophagectomy is the mainstay of esophageal cancer treatment but anastomotic insufficiency related morbidity and mortality remain challenging for patient outcome. Methods: A live porcine model (n=50) for MIE was used with gastric conduit formation and linear stapled side-to-side esophagogastrostomy. Four main experimental groups differed in stapling length (3 vs. 6 cm) and anastomotic position on the conduit (cranial vs. caudal). Tissue oxygenation around the anastomotic site was evaluated using HSI and was validated with histopathology. Results: The tissue oxygenation (ΔStO2) after the anastomosis remained constant only for the short stapler in caudal position (-0.4±4.4%, n.s.) while it dropped markedly in the other groups (short-cranial: -15.6±11.5%, p=0.0002; long-cranial: -20.4±7.6%, p=0.0126; long-caudal: -16.1±9.4%, p<0.0001) Tissue samples from deoxygenated stomach as measured by HSI showed correspondent eosinophilic pre-necrotic changes in 35.7±9.7% of the surface area. Conclusions: Tissue oxygenation at the anastomotic site of the gastric conduit during MIE is influenced by stapling technique. Optimal oxygenation was achieved with a short stapler (3 cm) and sufficient distance of the anastomosis to the cranial end of the gastric conduit. HSI tissue deoxygenation corresponded to histopathologic necrotic tissue changes. These findings allow for optimization of gastric conduit perfusion and anastomotic technique in MIE.

Background: Social media (SoMe) has become a powerful platform for distributing health information. Facial palsy (FP) results in functional and social impairment and lowers quality of life. Social media may help to raise awareness of FP sequalae. This study aims to determine the FP information growth on SoMe platforms and parameters that influence user engagement on FP content. Methods: Five commonly used SoMe platforms (Facebook, Instagram, TikTok, Twitter, and Reddit) were analyzed. Data on 18 FP hashtags and their social interaction parameters (posts, likes, reaches, comments, shares, language, and country of origin) over the past 5 years (July 31, 2016, to July 31, 2021) were collected. In-depth account analysis was performed on the 5 most popular Instagram profiles associated with FP. Results: The annual growth curve was positive on each platform. Facial Palsy Awareness Week 2021 trended best on TikTok. Facebook accumulated 315,411 likes and 1,922,678 reaches on 8356 posts. On Instagram, 24,968 posts gathered 4,904,124 likes and 9,215,852 reaches. TikTok users interacted on 3565 posts, accumulating 4,304,155 likes and 4,200,368 reaches. The implementation of reels (P<0.001) and the profile host interacting with their followers by liking (P<0.001) and replying (P<0.001) to users’ comments significantly increased the engagement rate. Conclusions: Facial palsy is of increasing interest on SoMe. Facial palsy surgeons may post reels, interact with their community, and engage into FPAW to promote user engagement.