Indocyanine Green Fluorescence Measurement of Intestinal Transit and Gut Perfusion after Intestinal Manipulation

Abstract

Background and Aims: Postoperative ileus is a common and poorly understood problem of abdominal surgery. The aim of this study was to measure postoperative intestinal transit and to evaluate bowel wall perfusion by a novel in vivo indocyanine green (ICG)-fluorescence measurement following intestinal manipulation (IM). Methods: Rats underwent a simple intestinal manipulation. Myeloperoxidase-positive cells in the muscularis were stained with the Hanker-Yates reaction and quantified histochemically. Bowel wall perfusion was determined directly and 24 h postoperatively using a laser-fluorescence detection unit. Intestinal transit was visualized 24 h after IM. Results: IM resulted in a massive infiltration (155-fold) of neutrophils into the intestinal muscularis 24 h postoperatively. Bowel wall perfusion significantly decreased directly and 24 h following surgery (29 and 59%, respectively). Gastrointestinal transit was similarly impaired and showed a reduction to 40% of the control values 24 h after IM. Conclusion: IM of the rat small intestine caused an impairment in bowel wall perfusion and microcirculation and a significant decrease in gastrointestinal transit. The ICG fluorescence measurement using the described system proved to be a simple and reliable method to evaluate intestinal transit and bowel wall microcirculation in vivo.

Influence of Temporary Abdominal Wall Repair on the Intestinal Integrity: An Experimental Study in the Rat

“…The intraluminal gastrointestinal distance of the ICG migration was 83 8 2.6 cm in sham-operated animals vs. 80 8 2.9 cm in mesh-implanted animals (p 6 0.05). These IC-View transit data correspond with the transit of control animals without surgery [10] and could therefore confirm the intestinal integrity of both experimental groups.…”

“…For motility studies, gastrointestinal transit was evaluated 48 h after surgery with the IC-View system [10] . The intestinal muscularis of these animals were used for histochemical studies, while peritoneal fluid and serum were used for TNF-␣ , IL-6 and malondialdehyde (MDA) measurements.…”

“…The aim of the present study was to analyze the postoperative intestinal integrity by in vivo indocyanine green (ICG)-fluorescence transit [10] and measurement of local and systemic inflammatory response following temporary abdominal wall repair with or without absorbable mesh augmentation in a rat model.…”

Postoperative Immune Suppression in Visceral Surgery: Characterisation of an Intestinal Mouse Model

“…The staining of neutrophil granulocytes in the muscularis mucosae 24 h following SID and IMM was performed as described previously [18,19]. In brief, whole mounts of mucosa-free muscularis were prepared from the jejunum.…”

Microdialysis Monitoring of Biomarkers for Early Recognition of Intestinal Ischemia

“…In order to monitor these perfusion irregularities, several techniques have been used over the years. Human GI perfusion has been monitored by means of tonometry (50)(51)(52), laser Doppler flowmetry (53,54), reflectance spectrophotometry (55), near-infrared spectroscopy (56), orthogonal polarisation spectral imaging, (57,58), indocyanine green clearance (59), and measurements of plasma D-lactate (60). While the outcome of patients with septic shock can be predicted, these techniques cannot be compared to each other since they measure different constituents of GI perfusion (61).…”