141 Real-time intestinal perfusion assessment for anastomotic site selection using LSCI Figure 1. Graphic representation of the experimental setup. Illustration made by Sieben Medical Art, © 2023 Sieben Medical Art. Surgical procedure and identification of three differently perfused intestinal loops After proper sedation and analgesia, laparoscopic instruments were introduced by an experienced colorectal surgeon (M.A-T.). During the experiment, a small bowel ischemic loop model was used that was previously described by Diana et al.22. In short, small bowel loops with a length of approximately 15 centimeters were selected and arteries at the mesenteric side of the small bowel loop were transected to impair perfusion. To evaluate the ability of surgeons to identify and differentiate ischemic intestinal loops with varying levels of perfusion using both LSCI derived visual feedback and conventional white light images, three differently perfused ischemic intestinal loops were created, each measuring approximately 15 centimeters in length. The first loop underwent tissue perfusion compromise through the dissection of 15 arteries 90 minutes prior to surgeon evaluation. The second loop underwent a lesser perfusion alteration with fewer dissected arteries, with the dissection of eight arteries occurring just five minutes before questioning. The third loop had unaltered perfusion. To assess the state of perfusion, three sections of the small bowel loops were selected: the middle section of the first loop (with compromised perfusion), the end section of the second loop (with more recent perfusion alteration and less compromised perfusion), and a section from a healthy loop (with normal perfusion). The state of perfusion was confirmed by three specialists who examined white light images of the tissue. Discoloration of the tissue, previously shown to be indicative of ischemic intestinal tissue using LSCI, was considered the 7
RkJQdWJsaXNoZXIy MTk4NDMw