Fluorescence angiography to assess intestinal viability during emergency laparoscopy for small bowel obstruction—A video vignette

Vaassen, H. G. M.; Sprakel, Joost; Lips, Daan J.

doi:10.1111/codi.16214

Cited by 4 publications

(4 citation statements)

References 2 publications

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“…Therefore, the bowel tissues photoluminescence intensity decreases. But the determination of the photoluminescence intensity evaluates total blood circulation disorders, not only the blood filling of vessels, as some known methods [10][11][12]15]. This happens because the laser ray penetrates through the tissues of the bowel wall.…”

Section: Discussionmentioning

confidence: 99%

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The determining the photoluminescence intensity for assessing of the small bowel viability in the experiment

2023

FEM

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Aims: Explore the potential of utilising photoluminescence intensity (PhLI) indicators for evaluating bowel viability. Methodology: PhLI of the small bowel walls on the initial, middle, and distal parts were measured in the control group (10 rats). The loop of the initial (10 rats), middle (10 rats) and distal (10 rats) part of the bowel with the mesentery was ligated. PhLI of the bowel walls were measured on the afferent (AP), efferent (EP) and ligated (LP) parts in 6 hours. LGN-503 argon laser with a wavelength of 458 nm and a power of 200 mW was used. Sections of bowels were taken for histological examinations. Results: In AP revealed dystrophic disorders, in EP revealed minor changes, in LP revealed necrosis. The small bowel wall PhLI with altered viability decreased at the wavelength range λ = 470-490 nm, but the absolute indicators were significantly variable. The ratio of PhLI at wavelengths λ = 474 nm/λ = 489 nm on the initial, middle, distal bowel's parts didn’t significantly differ in control. The ratio on each bowel part didn’t significantly differ on the AP, EP, LP. The ratio's differences of the viable and non-viable bowels were significant on each part. Conclusion: 1. The small bowel wall PhLI with altered viability decreases at the wavelength range λ = 470-490 nm. 2. The ratio of the small bowel walls PhLI indicators at the wavelengths λ=474/λ=489 nm is statistically significantly different in the bowel parts without altered viability and the bowel parts with necrosis. 3. Indicators of the ratio > 17 units testify the absence of viability altered, indicators in the range of 13-17 units testify the morphological disorders without necrosis, indicators < 13 units testify the bowel necrosis. 4. The determination of this ratio is promising for use in patients to assess its informativeness.

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Section: Discussionmentioning

confidence: 99%

“…Various ways have been proposed for the viability assessment [6][7][8][9][10][11][12][13][14][15]. Most of these ways determine the state of blood circulation in the vessels of bowel walls.…”

Section: Introductionmentioning

confidence: 99%

The determining the photoluminescence intensity for assessing of the small bowel viability in the experiment

2023

FEM

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“…But this way is subjective and not reliable enough [5,6]. There are many ways to objectively assessment [6][7][8][9][10][11][12][13][14][15][16]. Most of them determine the intensity of blood circulation in bowel wall tissues [7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

“…There are many ways to objectively assessment [6][7][8][9][10][11][12][13][14][15][16]. Most of them determine the intensity of blood circulation in bowel wall tissues [7][8][9][10][11]. But disruptions in blood circulation are not informative enough, since bowel necrosis begins in the mucous membrane [11], what such ways do not detect.…”

Section: Introductionmentioning

confidence: 99%

The use of laser radiation to assess the bowel viability in an experiment

2023

FEM

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Aims: To investigate the possibility of using laser rays scattering indicators to assess the bowel viability. Methodology: 30 white rats. A loop of the middle part of the small bowel (SB) with the mesentery was ligated in 10 rats. A loop of the middle part of the large bowel (LB) with the mesentery was ligated in 10 rats. The width of the laser rays at wavelengths λ=0.63 and λ=0.4 μm scattering zone (WLRSZ) was measured (in millimeters) on the afferent (AP), efferent (EP) and ligated (LP) parts of the bowel’s walls in the in 6 hours. Sections of bowels were taken for histological examination. The data obtained by measurements in 10 healthy animals were the control. Results: In AP revealed morphological disorders without signs of necrosis, in EP revealed minor changes, in LP revealed necrosis. We used the ratio of the WLRSZ at wavelengths λ=0.63/λ=0.4 μm. Control ratio on SB and LB didn’t differ significantly. AP ratio on SB and LB was not significantly different, but was significantly different from the control. EP ratio on SB and LB was not significantly different and did not differ significantly from the control, but differed significantly from the indicators on the AP. LP ratio indicators on SB and LB was not significantly different, but significantly different from the control, indicators on AP and EP. Conclusion: 1. The ratio of the laser rays at the wavelengths λ=0.63/λ=0.4 μm scattering zone width is statistically significantly different in the bowel parts without deviated viability, with morphological deviations without signs of necrosis, and with necrosis. 2. Ratio indicators > 1.58 units indicate preserved viability, indicators in the range of 1.4-1.35 units indicate morphological deviations without necrosis, indicators < 1.2 units indicate bowel necrosis. 3. The determination of this ratio should be used in patients to assess its informativeness. Aims: To investigate the possibility of using laser rays scattering indicators to assess the bowel viability. Methodology: 30 white rats. A loop of the middle part of the small bowel (SB) with the mesentery was ligated in 10 rats. A loop of the middle part of the large bowel (LB) with the mesentery was ligated in 10 rats. The width of the laser rays at wavelengths λ=0.63 and λ=0.4 μm scattering zone (WLRSZ) was measured (in millimeters) on the afferent (AP), efferent (EP) and ligated (LP) parts of the bowel’s walls in the in 6 hours. Sections of bowels were taken for histological examination. The data obtained by measurements in 10 healthy animals were the control. Results: In AP revealed morphological disorders without signs of necrosis, in EP revealed minor changes, in LP revealed necrosis. We used the ratio of the WLRSZ at wavelengths λ=0.63/λ=0.4 μm. Control ratio on SB and LB didn’t differ significantly. AP ratio on SB and LB was not significantly different, but was significantly different from the control. EP ratio on SB and LB was not significantly different and did not differ significantly from the control, but differed significantly from the indicators on the AP. LP ratio indicators on SB and LB was not significantly different, but significantly different from the control, indicators on AP and EP. Conclusion: 1. The ratio of the laser rays at the wavelengths λ=0.63/λ=0.4 μm scattering zone width is statistically significantly different in the bowel parts without deviated viability, with morphological deviations without signs of necrosis, and with necrosis. 2. Ratio indicators > 1.58 units indicate preserved viability, indicators in the range of 1.4-1.35 units indicate morphological deviations without necrosis, indicators < 1.2 units indicate bowel necrosis. 3. The determination of this ratio should be used in patients to assess its informativeness.

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Don’t forget indocyanine fluorescence-guided surgery in emergency settings

Coletta,

Patriti

2023

Updates Surg

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Fluorescence angiography to assess intestinal viability during emergency laparoscopy for small bowel obstruction—A video vignette

Cited by 4 publications

References 2 publications

The determining the photoluminescence intensity for assessing of the small bowel viability in the experiment

The determining the photoluminescence intensity for assessing of the small bowel viability in the experiment

The use of laser radiation to assess the bowel viability in an experiment

Don’t forget indocyanine fluorescence-guided surgery in emergency settings

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