TY - JOUR
T1 - Enhanced Surgical Imaging
T2 - Laparoscopic Vessel Identification and Assessment of Tissue Oxygenation
AU - Crane, Nicole J.
AU - McHone, Ben
AU - Hawksworth, Jason
AU - Pearl, Jonathan P.
AU - Denobile, John
AU - Tadaki, Doug
AU - Pinto, Peter A.
AU - Levin, Ira W.
AU - Elster, Eric A.
N1 - Funding Information:
We also acknowledge support from the intramural program of the National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health.
PY - 2008/6
Y1 - 2008/6
N2 - Background: Inherent to minimally invasive procedures are loss of tactile feedback and loss of three-dimensional assessment. Tasks such as vessel identification and dissection are not trivial for the inexperienced laparoscopic surgeon. Advanced surgical imaging, such as 3-charge-coupled device (3-CCD) image enhancement, can be used to assist with these more challenging tasks and, in addition, offers a method to noninvasively monitor tissue oxygenation during operations. Study Design: In this study, 3-CCD image enhancement is used for identification of vessels in 25 laparoscopic donor and partial nephrectomy patients. The algorithm is then applied to two laparoscopic nephrectomy patients involving multiple renal arteries. We also use the 3-CCD camera to qualitatively monitor renal parenchymal oxygenation during 10 laparoscopic donor nephrectomies (LDNs). Results: The mean region of interest (ROI) intensity values obtained for the renal artery and vein (68.40 ± 8.44 and 45.96 ± 8.65, respectively) are used to calculate a threshold intensity value (59.00) that allows for objective vessel differentiation. In addition, we examined the renal parenchyma during LDNs. Mean ROI intensity values were calculated for the renal parenchyma at two distinct time points: before vessel stapling (nonischemic) and just before extraction from the abdomen (ischemic). The nonischemic mean ROI intensity values are statistically different from the ischemic mean ROI intensity values (p < 0.05), even with short ischemia times. Conclusions: We have developed a technique, 3-CCD image enhancement, for identification of vasculature and monitoring of parenchymal oxygenation. This technique requires no additional laparoscopic operating room equipment and has real-time video capability.
AB - Background: Inherent to minimally invasive procedures are loss of tactile feedback and loss of three-dimensional assessment. Tasks such as vessel identification and dissection are not trivial for the inexperienced laparoscopic surgeon. Advanced surgical imaging, such as 3-charge-coupled device (3-CCD) image enhancement, can be used to assist with these more challenging tasks and, in addition, offers a method to noninvasively monitor tissue oxygenation during operations. Study Design: In this study, 3-CCD image enhancement is used for identification of vessels in 25 laparoscopic donor and partial nephrectomy patients. The algorithm is then applied to two laparoscopic nephrectomy patients involving multiple renal arteries. We also use the 3-CCD camera to qualitatively monitor renal parenchymal oxygenation during 10 laparoscopic donor nephrectomies (LDNs). Results: The mean region of interest (ROI) intensity values obtained for the renal artery and vein (68.40 ± 8.44 and 45.96 ± 8.65, respectively) are used to calculate a threshold intensity value (59.00) that allows for objective vessel differentiation. In addition, we examined the renal parenchyma during LDNs. Mean ROI intensity values were calculated for the renal parenchyma at two distinct time points: before vessel stapling (nonischemic) and just before extraction from the abdomen (ischemic). The nonischemic mean ROI intensity values are statistically different from the ischemic mean ROI intensity values (p < 0.05), even with short ischemia times. Conclusions: We have developed a technique, 3-CCD image enhancement, for identification of vasculature and monitoring of parenchymal oxygenation. This technique requires no additional laparoscopic operating room equipment and has real-time video capability.
UR - http://www.scopus.com/inward/record.url?scp=44149099027&partnerID=8YFLogxK
U2 - 10.1016/j.jamcollsurg.2008.01.013
DO - 10.1016/j.jamcollsurg.2008.01.013
M3 - Article
C2 - 18501814
AN - SCOPUS:44149099027
SN - 1072-7515
VL - 206
SP - 1159
EP - 1166
JO - Journal of the American College of Surgeons
JF - Journal of the American College of Surgeons
IS - 6
ER -