Transanal Laser Doppler Flowmetry to Assess Microcirculation in the Upper Rectum During Abdominal Aortic Aneurysmectomy

Abstract

Transanal rectal LDF is useful for continuously assessing microcirculation in the rectal mucosa during abdominal aneurysmectomy, and the data obtained with this method may reflect whether a collateral pathway to the upper rectum exists.

Vascular Anatomy of the Rectal Stump After Total Mesorectal Excision

“…It is probable that the SRA could have a different role in the vascularization of the distal rectum depending on the role performed by the collateral iliac vascularization. 52 The functional adaptations of the vascularization of the rectal stump occur in the immediate postoperative period (the first hours or first days) without any further modification. These data are confirmed by the results of the angio CT at three months.…”

Enhanced Surgical Imaging: Laparoscopic Vessel Identification and Assessment of Tissue Oxygenation

“…Intraoperative Doppler ultrasound can be used but also requires specialized equipment and personnel. Vascular surgeons have used laser Doppler flowmetry (20) and venous sampling (21) to assess adequate perfusion and oxygenation to tissues, respectively. These however, have not been adapted to the laparoscopic setting and are limited in that they do not allow for real-time imaging.…”

“…Vascular surgeons, during open and endovascular abdominal aortic aneurysm (AAA) repair have sought ways to detect ischemic colitis intraoperatively before the procedure is completed (20,21,25,38). Similar technology is being investigated by cardiac surgeons to assess graft-patency intraoperatively during coronary artery bypass grafts (26)(27)(28).…”