Intraoperative Laparoscopic Hyperspectral Imaging during Esophagectomy—A Pilot Study Evaluating Esophagogastric Perfusion at the Anastomotic Sites
Hyperspectral imaging (HSI) is a non-invasive and contactless technique that enables the real-time acquisition of comprehensive information on tissue within the surgical field. In this pilot study, we investigated whether a new HSI system for minimally-invasive surgery, TIVITA<sup>®</sup>...
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MDPI AG
2024-01-01
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| Series: | Bioengineering |
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| Online Access: | https://www.mdpi.com/2306-5354/11/1/69 |
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| author | Annalena Ilgen Hannes Köhler Annekatrin Pfahl Sigmar Stelzner Matthias Mehdorn Boris Jansen-Winkeln Ines Gockel Yusef Moulla |
| author_facet | Annalena Ilgen Hannes Köhler Annekatrin Pfahl Sigmar Stelzner Matthias Mehdorn Boris Jansen-Winkeln Ines Gockel Yusef Moulla |
| author_sort | Annalena Ilgen |
| collection | DOAJ |
| description | Hyperspectral imaging (HSI) is a non-invasive and contactless technique that enables the real-time acquisition of comprehensive information on tissue within the surgical field. In this pilot study, we investigated whether a new HSI system for minimally-invasive surgery, TIVITA<sup>®</sup> Mini (HSI-MIS), provides reliable insights into tissue perfusion of the proximal and distal esophagogastric anastomotic sites during 21 laparoscopic/thoracoscopic or robotic Ivor Lewis esophagectomies of patients with cancer to minimize the risk of dreaded anastomotic insufficiency. In this pioneering investigation, physiological tissue parameters were derived from HSI measurements of the proximal site of the anastomosis (esophageal stump) and the distal site of the anastomosis (tip of the gastric conduit) during the thoracic phase of the procedure. Tissue oxygenation (StO<sub>2</sub>), Near Infrared Perfusion Index (NIR-PI), and Tissue Water Index (TWI) showed similar median values at both anastomotic sites. Significant differences were observed only for NIR-PI (median: 76.5 vs. 63.9; <i>p</i> = 0.012) at the distal site (gastric conduit) compared to our previous study using an HSI system for open surgery. For all 21 patients, reliable and informative measurements were attainable, confirming the feasibility of HSI-MIS to assess anastomotic viability. Further studies on the added benefit of this new technique aiming to reduce anastomotic insufficiency are warranted. |
| first_indexed | 2024-03-08T11:05:34Z |
| format | Article |
| id | doaj.art-a416a460c7bc44fc9e1d3745caf3784c |
| institution | Directory Open Access Journal |
| issn | 2306-5354 |
| language | English |
| last_indexed | 2024-03-08T11:05:34Z |
| publishDate | 2024-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Bioengineering |
| spelling | doaj.art-a416a460c7bc44fc9e1d3745caf3784c2024-01-26T15:06:22ZengMDPI AGBioengineering2306-53542024-01-011116910.3390/bioengineering11010069Intraoperative Laparoscopic Hyperspectral Imaging during Esophagectomy—A Pilot Study Evaluating Esophagogastric Perfusion at the Anastomotic SitesAnnalena Ilgen0Hannes Köhler1Annekatrin Pfahl2Sigmar Stelzner3Matthias Mehdorn4Boris Jansen-Winkeln5Ines Gockel6Yusef Moulla7Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital of Leipzig, Liebigstr. 20, 04103 Leipzig, GermanyInnovation Center Computer Assisted Surgery (ICCAS), Faculty of Medicine, Leipzig University, Semmelweisstr. 14, 04103 Leipzig, GermanyInnovation Center Computer Assisted Surgery (ICCAS), Faculty of Medicine, Leipzig University, Semmelweisstr. 14, 04103 Leipzig, GermanyDepartment of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital of Leipzig, Liebigstr. 20, 04103 Leipzig, GermanyDepartment of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital of Leipzig, Liebigstr. 20, 04103 Leipzig, GermanyDepartment of General, Visceral, Thoracic and Vascular Surgery, Klinikum St. Georg, Delitzscher Str. 141, 04129 Leipzig, GermanyDepartment of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital of Leipzig, Liebigstr. 20, 04103 Leipzig, GermanyDepartment of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital of Leipzig, Liebigstr. 20, 04103 Leipzig, GermanyHyperspectral imaging (HSI) is a non-invasive and contactless technique that enables the real-time acquisition of comprehensive information on tissue within the surgical field. In this pilot study, we investigated whether a new HSI system for minimally-invasive surgery, TIVITA<sup>®</sup> Mini (HSI-MIS), provides reliable insights into tissue perfusion of the proximal and distal esophagogastric anastomotic sites during 21 laparoscopic/thoracoscopic or robotic Ivor Lewis esophagectomies of patients with cancer to minimize the risk of dreaded anastomotic insufficiency. In this pioneering investigation, physiological tissue parameters were derived from HSI measurements of the proximal site of the anastomosis (esophageal stump) and the distal site of the anastomosis (tip of the gastric conduit) during the thoracic phase of the procedure. Tissue oxygenation (StO<sub>2</sub>), Near Infrared Perfusion Index (NIR-PI), and Tissue Water Index (TWI) showed similar median values at both anastomotic sites. Significant differences were observed only for NIR-PI (median: 76.5 vs. 63.9; <i>p</i> = 0.012) at the distal site (gastric conduit) compared to our previous study using an HSI system for open surgery. For all 21 patients, reliable and informative measurements were attainable, confirming the feasibility of HSI-MIS to assess anastomotic viability. Further studies on the added benefit of this new technique aiming to reduce anastomotic insufficiency are warranted.https://www.mdpi.com/2306-5354/11/1/69hyperspectral imagingminimally invasive/robotic surgeryclinical evaluation studygastrointestinal surgeryintraoperative imagingesophagectomy |
| spellingShingle | Annalena Ilgen Hannes Köhler Annekatrin Pfahl Sigmar Stelzner Matthias Mehdorn Boris Jansen-Winkeln Ines Gockel Yusef Moulla Intraoperative Laparoscopic Hyperspectral Imaging during Esophagectomy—A Pilot Study Evaluating Esophagogastric Perfusion at the Anastomotic Sites Bioengineering hyperspectral imaging minimally invasive/robotic surgery clinical evaluation study gastrointestinal surgery intraoperative imaging esophagectomy |
| title | Intraoperative Laparoscopic Hyperspectral Imaging during Esophagectomy—A Pilot Study Evaluating Esophagogastric Perfusion at the Anastomotic Sites |
| title_full | Intraoperative Laparoscopic Hyperspectral Imaging during Esophagectomy—A Pilot Study Evaluating Esophagogastric Perfusion at the Anastomotic Sites |
| title_fullStr | Intraoperative Laparoscopic Hyperspectral Imaging during Esophagectomy—A Pilot Study Evaluating Esophagogastric Perfusion at the Anastomotic Sites |
| title_full_unstemmed | Intraoperative Laparoscopic Hyperspectral Imaging during Esophagectomy—A Pilot Study Evaluating Esophagogastric Perfusion at the Anastomotic Sites |
| title_short | Intraoperative Laparoscopic Hyperspectral Imaging during Esophagectomy—A Pilot Study Evaluating Esophagogastric Perfusion at the Anastomotic Sites |
| title_sort | intraoperative laparoscopic hyperspectral imaging during esophagectomy a pilot study evaluating esophagogastric perfusion at the anastomotic sites |
| topic | hyperspectral imaging minimally invasive/robotic surgery clinical evaluation study gastrointestinal surgery intraoperative imaging esophagectomy |
| url | https://www.mdpi.com/2306-5354/11/1/69 |
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