Hyperspectral Imaging (HSI) in anatomic left liver resection

Sucher, Robert; Alvanos, Athanasios; Köhler, Helmut; Wagner, Tristan; Brunotte, Maximilian; Lederer, Andri; Gockel, Ines; Seehofer, Daniel

doi:10.1016/j.ijscr.2019.08.025

Cited by 40 publications

(33 citation statements)

References 15 publications

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“…HSI creates high-resolution images that contribute information about oxygenation or ischemia in superficial tissue layers. Several experimental and clinical studies have shown that HSI delivers reliable data in wounds (diabetic, peripheral arterial occlusive disease, burn) [28][29][30][31][32][33], oncologic surgery (esophagectomy) [34], intestinal resections [35], left liver resection [36] and maxillofacial surgery [37].…”

Section: Introductionmentioning

confidence: 99%

Hyperspectral Imaging (HSI) as a new diagnostic tool in free flap monitoring for soft tissue reconstruction: a proof of concept study

et al. 2021

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Objectives Free flap surgery is an essential procedure in soft tissue reconstruction. Complications due to vascular compromise often require revision surgery or flap removal. We present hyperspectral imaging (HSI) as a new tool in flap monitoring to improve sensitivity compared to established monitoring tools. Methods We performed a prospective observational cohort study including 22 patients. Flap perfusion was assessed by standard clinical parameters, Doppler ultrasound, and HSI on t0 (0 h), t1 (16–28 h postoperatively), and t2 (39–77 h postoperatively). HSI records light spectra from 500 to 1000 nm and provides information on tissue morphology, composition, and physiology. These parameters contain tissue oxygenation (StO2), near-infrared perfusion- (NIR PI), tissue hemoglobin- (THI), and tissue water index (TWI). Results Total flap loss was seen in n = 4 and partial loss in n = 2 cases. Every patient with StO2 or NIR PI below 40 at t1 had to be revised. No single patient with StO2 or NIR PI above 40 at t1 had to be revised. Significant differences between feasable (StO2 = 49; NIR PI = 45; THI = 16; TWI = 56) and flaps with revision surgery [StO2 = 28 (p < 0.001); NIR PI = 26 (p = 0.002); THI = 56 (p = 0.002); TWI = 47 (p = 0.045)] were present in all HSI parameters at t1 and even more significant at t2 (p < 0.0001). Conclusion HSI provides valuable data in free flap monitoring. The technique seems to be superior to the gold standard of flap monitoring. StO2 and NIR PI deliver the most valuable data and 40 could be used as a future threshold in surgical decision making. Clinical Trial Register This study is registered at the German Clinical Trials Register (DRKS) under the registration number DRKS00020926.

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Section: Introductionmentioning

confidence: 99%

Hyperspectral Imaging (HSI) as a new diagnostic tool in free flap monitoring for soft tissue reconstruction: a proof of concept study

et al. 2021

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“…In the case of laparoscopic pCCA surgery, a standardized procedure for intraoperative bile leakage testing is still in demand. Enhanced intraoperative visualization techniques such as near infrared indocyanine green staining methods 4 , 5 and hyperspectral imaging 6 might add substantial benefits to the identification of not only vascular structures but also biliary structures. In our opinion, these novel technologies might well be exploited for the specific detection of biliary leaks in future laparoscopic liver surgery.…”

Section: Futurementioning

confidence: 99%

ASO Author Reflections: Hepatobiliary Surgeons are Spurred to Implement Totally Minimally Invasive Techniques for Perihilar Cholangiocarcinoma Surgery

Sucher

Seehofer

2020

Ann Surg Oncol

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The ongoing revolution in laparoscopic liver surgery has delivered scientific evidence of improved short-term outcomes and uncompromised long-term oncologic results for patients with resectable malignant liver disease, including cholangiocarcinoma (CCA) cases. 1 Technically demanding surgical steps, such as radical lymphadenectomy and extrahepatic bile duct resection with biliary reconstruction, are mandatory in patients with perihilar CCA (pCCA). However, minimally invasive pCCA surgery remained the last garrison, currently intended to be stormed by a plethora of specialized hepatobiliary surgeons. 2

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“…In brief, this system provides colored pictures for surgeons indicating the oxygen saturation (StO 2 ), tissue perfusion (NIR-PI), organ hemoglobin index (OHI) and tissue water index. The application of HSI may have an impact on surgical guidance through tissue characterization [ 14 , 15 , 16 ]. This study aimed to evaluate the clinical impact of using HSI in determining the perfusion of the liver and the stomach during pancreatoduodenectomy (PD).…”

Section: Introductionmentioning

confidence: 99%

Hyperspectral Imaging (HSI)—A New Tool to Estimate the Perfusion of Upper Abdominal Organs during Pancreatoduodenectomy

Moulla

Buchloh

Köhler

et al. 2021

Cancers

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Hyperspectral imaging (HSI) in abdominal surgery is a new non-invasive tool for the assessment of the perfusion and oxygenation of various tissues and organs. Its benefit in pancreatic surgery is still unknown. The aim of this study was to evaluate the key impact of using HSI during pancreatoduodenectomy (PD). In total, 20 consecutive patients were included. HSI was recorded during surgery as part of a pilot study approved by the local Ethics Committee. Data were collected prospectively with the TIVITA® Tissue System. Intraoperative HS images were recorded before and after gastroduodenal artery (GDA) clamping. We detected four patients with celiac artery stenosis (CAS) caused by a median arcuate ligament (MAL). In two of these patients, a reduction in liver oxygenation (StO2) was discovered 15 and 30 min after GDA clamping. The MAL was divided in these patients. HSI showed an improvement of liver StO2 after MAL division (from 61% to 73%) in one of these two patients. There was no obvious decrease in liver StO2 in the other two patients with CAS. HSI, as a non-invasive procedure, could be helpful in evaluating liver and gastric perfusion during PD, which might assist surgeons in choosing the best surgical approach and in improving patients’ outcomes.

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Hyperspectral Imaging (HSI) in anatomic left liver resection

Cited by 40 publications

References 15 publications

Hyperspectral Imaging (HSI) as a new diagnostic tool in free flap monitoring for soft tissue reconstruction: a proof of concept study

Hyperspectral Imaging (HSI) as a new diagnostic tool in free flap monitoring for soft tissue reconstruction: a proof of concept study

ASO Author Reflections: Hepatobiliary Surgeons are Spurred to Implement Totally Minimally Invasive Techniques for Perihilar Cholangiocarcinoma Surgery

Hyperspectral Imaging (HSI)—A New Tool to Estimate the Perfusion of Upper Abdominal Organs during Pancreatoduodenectomy

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