Laparoscopic Diagnostics of Acute Bowel Ischemia Using Ultraviolet Light and Fluorescein Dye: An Experimental Study

Abstract

The method should be considered a valuable diagnostic procedure both for diagnostics of early stage of acute bowel ischemia and for second-look procedures.

Porcine models of digestive disease: the future of large animal translational research

“…Approximating the human size is also crucial in the development and testing of imaging modalities for early diagnosis of AMI (91, 125). This is likely why research focused on improving early diagnosis of AMI commonly utilizes porcine models to evaluate the efficacy of imaging modalities such as radiography, angiography, computed tomography and magnetic resonance imaging (50–52, 106, 126). …”

Fluorescent test accurately predicts leak of ischemic colon anastomosis in rats

“…Luminescence clearly differentiates well perfused from ischemic tissues 12 . The sensitivity and specificity of this technique are close to 100% 11,14 . Currently, fluorescence method to evaluate the perfusion of intestinal anastomoses has been increasingly used in robotic-assisted and laparoscopic colorectal resections, such as left colectomies and rectal ressections.…”

“…The ideal evaluation method of intestinal perfusion should be easily accessed in the operating room, quick to use, have good accuracy, low cost and be minimallyinvasive 12 . The fluorescence method with intravenous administration of fluorescein and examination under ultraviolet light meet all these criteria 7,[10][11][12]14 . The present study comprised a control group (non-ischemic anastomosis) and three intervention groups with varying degrees of ischemic colonic anastomosis in rats.…”

“…Clinical tests to predict the occurrence of anastomotic dehiscence have very low accuracy, with a failure rate up to 60% 4,[7][8][9] . Several studies have been conducted to find an objective and reliable method of intraoperative evaluation of intestinal blood supply in the last four decades 2,3,7,[10][11][12][13][14] . To present date, no method has been accepted as the standard for this matter, however fluorescence tests have gained some attention [16][17][18][19][20][21][22] .…”

Combination of diagnostic laparoscopy and intraoperative indocyanine green fluorescence angiography for the early detection of intestinal ischemia not detectable at CT scan

“…Despite diagnostic laparoscopy is an invaluable tool and can be conducted at bedside in ICU patients, it has unfortunately a reduced sensitivity in the early stages of intestinal ischemia, due to the fact that the mucosa can be extensively ischemic while the bowel might still appear normal at external inspection. This drawback can be overcome by using fluorescein-assisted laparoscopy, with which even early stages of ischemia can be identified [8] .…”