Comparison of the ViOptix Intra.Ox Near Infrared Tissue Spectrometer and Indocyanine Green Angiography in a Porcine Bowel Model

Khavanin, Nima; Almaazmi, Hamda; Darrach, Halley; Kraenzlin, Franca; Safar, Bashar; Sacks, Justin M.

doi:10.1055/s-0040-1702163

Cited by 4 publications

(4 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Furthermore, this technique has only been previously described in an animal model, allowing much greater ischaemia than experienced clinically [ 38 ]), while mitochondrial respiration assessment necessitates full thickness biopsies. Non-invasive tissue oxygen saturation hyperspectral oximetry measurement [ 39 ] has potential but is still of uncertain clinical relevance and there is currently no CE-marked device for use in Europe [ 40 , 41 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical and computational development of a patient-calibrated ICGFA bowel transection recommender

Dalli,

Epperlein,

Hardy

et al. 2024

Surg Endosc

View full text Add to dashboard Cite

Introduction Intraoperative indocyanine green fluorescence angiography (ICGFA) aims to reduce colorectal anastomotic complications. However, signal interpretation is inconsistent and confounded by patient physiology and system behaviours. Here, we demonstrate a proof of concept of a novel clinical and computational method for patient calibrated quantitative ICGFA (QICGFA) bowel transection recommendation. Methods Patients undergoing elective colorectal resection had colonic ICGFA both immediately after operative commencement prior to any dissection and again, as usual, just before anastomotic construction. Video recordings of both ICGFA acquisitions were blindly quantified post hoc across selected colonic regions of interest (ROIs) using tracking-quantification software and computationally compared with satisfactory perfusion assumed in second time-point ROIs, demonstrating 85% agreement with baseline ICGFA. ROI quantification outputs detailing projected perfusion sufficiency-insufficiency zones were compared to the actual surgeon-selected transection/anastomotic construction site for left/right-sided resections, respectively. Anastomotic outcomes were recorded, and tissue lactate was also measured in the devascularised colonic segment in a subgroup of patients. The novel perfusion zone projections were developed as full-screen recommendations via overlay heatmaps. Results No patient suffered intra- or early postoperative anastomotic complications. Following computational development (n = 14) the software recommended zone (ROI) contained the expert surgical site of transection in almost all cases (Jaccard similarity index 0.91) of the nine patient validation series. Previously published ICGFA time-series milestone descriptors correlated moderately well, but lactate measurements did not. High resolution augmented reality heatmaps presenting recommendations from all pixels of the bowel ICGFA were generated for all cases. Conclusions By benchmarking to the patient’s own baseline perfusion, this novel QICGFA method could allow the deployment of algorithmic personalised NIR bowel transection point recommendation in a way fitting existing clinical workflow.

show abstract

Section: Discussionmentioning

confidence: 99%

Clinical and computational development of a patient-calibrated ICGFA bowel transection recommender

Dalli,

Epperlein,

Hardy

et al. 2024

Surg Endosc

View full text Add to dashboard Cite

show abstract

“…Intraoperative monitoring of renal allograft reperfusion was performed using a handheld, non-invasive, and FDA-approved NIRS tissue oximetry sensor device (Intra.Ox, ViOptix, Inc. Newark, CA, USA) that can provide real-time and instantaneous rSO 2 measurements [ 16 , 18 ]. During the surgical procedure, rSO 2 levels were measured pre- and post-reperfusion (i.e., removal of vascular clamps) at 3, 5, 10, and 20 min by placing the device directly over three regions of the allograft: upper pole (UP), renal hilum (RH), and lower pole (LP).…”

Section: Methodsmentioning

confidence: 99%

“…Despite the proven benefits, the utilization of NIRS devices to monitor allograft perfusion has not been investigated intraoperatively because of their inconveniently bulky size and in adult KT due to the large skin-to-kidney distance [ 15 ]. A wireless, non-invasive, and handheld NIRS device was recently developed and approved by the FDA; however, its use has only been studied in porcine skin flap and bowel models [ 16 , 17 , 18 ] to our knowledge.…”

Section: Introductionmentioning

confidence: 99%

Intraoperative Near-Infrared Spectroscopy Monitoring of Renal Allograft Reperfusion in Kidney Transplant Recipients: A Feasibility and Proof-of-Concept Study

Lau

López

Eguchi

et al. 2021

JCM

View full text Add to dashboard Cite

Conventional renal function markers are unable to measure renal allograft perfusion intraoperatively, leading to delayed recognition of initial allograft function. A handheld near-infrared spectroscopy (NIRS) device that can provide real-time assessment of renal allograft perfusion by quantifying regional tissue oxygen saturation levels (rSO2) was approved by the FDA. This pilot study evaluated the feasibility of intraoperative NIRS monitoring of allograft reperfusion in renal transplant recipients (RTR). Intraoperative renal allograft rSO2 and perfusion rates were measured in living (LDRT, n = 3) and deceased donor RTR (DDRT, n = 4) during the first 50 min post-reperfusion and correlated with renal function markers 30 days post-transplantation. Intraoperative renal allograft rSO2 for the DDRT group remained significantly lower than the LDRT group throughout the 50 min. Reperfusion rates were significantly faster in the LDRT group during the first 5 min post-reperfusion but remained stable thereafter in both groups. Intraoperative rSO2 were similar among the upper pole, renal hilum, and lower pole, and strongly correlated with allograft function and hemodynamic parameters up to 14 days post-transplantation. NIRS successfully detected differences in intraoperative renal allograft rSO2, warranting future studies to evaluate it as an objective method to measure ischemic injury and perfusion for the optimization of preservation/reperfusion protocols and early prediction of allograft function.

show abstract

“…A recent study has presented encouraging first data supporting the use of Intra.OxÔ for intraoperative tissue oxygenation measurements following large bowel resection and vessel ligation in a porcine model. 22 However, only 2 animals were included, and intestinal anastomoses were not conducted in that study. In a more comprehensive approach, we implemented a large-scale porcine model mimicking critical ischemia in the small bowel to investigate both the applicability and efficacy of Intra.-OxÔ in assessing intestinal tissue perfusion and exploring the association between low StO 2 and AL following intestinal anastomosis.…”

Section: Introductionmentioning

confidence: 99%

Assessment of Anastomotic Viability With Spectroscopic Real-time Oxygen Saturation Measurement in a Porcine Study

Khosrawipour

Steward

et al. 2022

Surg Innov

View full text Add to dashboard Cite

Objective Anastomotic leakage (AL) is a severe complication following intestinal procedures. Intra.Ox™ by ViOptix Inc (Newark, CA, USA) is a novel, FDA-approved spectroscopic device which enables real-time measurement of mixed tissue oxygen saturation (StO2). Using a porcine model, this study explores the correlation between StO2 measurements and AL formation as well as investigates the applicability of Intra.Ox™ in the clinical setting. Methods Eleven female swine were divided into 3 groups to explore AL formation in different ischemic conditions. Group 1: 100% mesenteric-vascular ligation, n = 3; Group 2: 50% ligation, n = 5; Group 3: No mesenteric ligation, n = 3. StO2 at the anastomotic line was measured before and after vessel ligation and anastomosis. Measurements were taken at 6 distinct locations along afferent and efferent loops. AL was evaluated on postoperative day 5 by re-laparotomy. Results AL rate was 100%, 60% and 0% in groups 1, 2 and 3, respectively. Post-anastomotic StO2 in group 1 (22.9 ± 18.5%) and 2 (39.2 ± 20.1%) were significantly lower than in group 3 (53.1 ± 8.3%, p<.0001). Post-anastomotic StO2 readings ≤40% indicated AL potential with 100% sensitivity,+ 80% specificity, positive predictive value of 85.7% and negative predictive value of 100%. Conclusion This study demonstrates the value of Intra.Ox™ in assessing local perfusion and indicate the association between low StO2 and AL by providing accurate, real-time, noninvasive tissue oxygenation measurements at anastomotic sites. Further studies are required to investigate the clinical application of this novel device in intestinal surgery.

show abstract

Comparison of the ViOptix Intra.Ox Near Infrared Tissue Spectrometer and Indocyanine Green Angiography in a Porcine Bowel Model

Cited by 4 publications

References 32 publications

Clinical and computational development of a patient-calibrated ICGFA bowel transection recommender

Clinical and computational development of a patient-calibrated ICGFA bowel transection recommender

Intraoperative Near-Infrared Spectroscopy Monitoring of Renal Allograft Reperfusion in Kidney Transplant Recipients: A Feasibility and Proof-of-Concept Study

Assessment of Anastomotic Viability With Spectroscopic Real-time Oxygen Saturation Measurement in a Porcine Study

Contact Info

Product

Resources

About