How to assess intestinal viability during surgery: A review of techniques

Abstract

Objective and quantitative intraoperative methods of bowel viability assessment are essential in gastrointestinal surgery. Exact determination of the borderline of the viable bowel with the help of an objective test could result in a decrease of postoperative ischemic complications. An accurate, reproducible and cost effective method is desirable in every operating theater dealing with abdominal operations. Numerous techniques assessing various parameters of intestinal viability are described by the studies. However, there is no consensus about their clinical use. To evaluate the available methods, a systematic search of the English literature was performed. Virtues and drawbacks of the techniques and possibilities of clinical application are reviewed. Valuable parameters related to postoperative intestinal anastomotic or stoma complications are analyzed. Important issues in the measurement and interpretation of bowel viability are discussed. To date, only a few methods are applicable in surgical practice.Further studies are needed to determine the limiting values of intestinal tissue oxygenation and flow indicative of ischemic complications and to standardize the methods.

Intraoperative monitoring of intestinal viability: Evaluation of a new combined sensor

“…In the hope of finding an ideal monitoring technique to assess intestinal viability, several techniques have been introduced like pulse oximetry, near infrared and visible spectrophotometry (NIRS & VLS), and laser Doppler flowmetry [7]. To date, however, no ideal monitoring method is available for day-to-day clinical use, indicating the need for continued investigation in this field.…”

Fundamental Study on Intraoperative Quantification of Gastrointestinal Viability by Transmission Light Intensity Analysis

“…Other groups [3]- [5] presented estimation methods of oxygen saturation based on reflected intensity analysis. In these studies, improving the accuracy of determination is difficult due to the difference of the optical path and the depth of light invasion quantitative evaluation base cimeter [6] is not practical b motion artifacts is large. A tion [7], it is necessary to de…”

Evaluation of the optical interference in a combined measurement system used for assessment of tissue blood flow

“…The results presented here are part of a wider study in which a combination of LDF and PPG methods is used for assessment of perfusion in bowel tissue for patients undergoing bowel resection. Determination of bowel viability following bowel resection is essential in gastrointestinal surgery [1,2,3]. Monitoring blood flow in abdominal surgery especially intra and post-operatively would be a valuable tool for prevention of intestinal ischemia and necrosis, often requiring surgical re-exploration, resulting in significant postoperative morbidity and increased length of hospital stay.…”