April 2019
Spotlight Summary by Ronald Sroka
Application of laser speckle contrast imaging in laparoscopic surgery
Anastomotic leakage (damage of the intestinal wall) is a major worldwide problem in surgery, e.g., of the gastrointestinal tract, leading to an enormous burden for both the patient and the hospital. Prolonged intensive care time and added costs are high. The experience of the surgeon and his applied techniques influence the postoperative outcome. As the state of microcirculation is one factor used to immediately evaluate the operative success, a gold standard technique suitable for laparoscopic use, while being robust and preferably noninvasive, is required.
Current techniques to analyze the state of microcirculation are laser Doppler flowmetry, indocyanine green imaging, hyperspectral imaging, and laser speckle contrast imaging (LSCI). Each of them have shown some limitations and disadvantages in the past. This paper meets the clinical needs by investigating the use of LSCI in combination with a commercially available laparoscopic video system in an experimental set-up mimicking a clinical situation. In addition, this approach was used in a low cohort clinical study where it could be illustrated that ischemic areas on the large intestine could be identified.
Thus, the LCSI technology shows potential for a fast, non-contact, full-field, and cost-effective technique which, in the case of adapting it to general endoscopes, also could be translated to further clinical applications. Prior to this, its real clinical impact should be proven in randomized clinical trials and in comparison to conventional clinical as well as competing techniques.
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Current techniques to analyze the state of microcirculation are laser Doppler flowmetry, indocyanine green imaging, hyperspectral imaging, and laser speckle contrast imaging (LSCI). Each of them have shown some limitations and disadvantages in the past. This paper meets the clinical needs by investigating the use of LSCI in combination with a commercially available laparoscopic video system in an experimental set-up mimicking a clinical situation. In addition, this approach was used in a low cohort clinical study where it could be illustrated that ischemic areas on the large intestine could be identified.
Thus, the LCSI technology shows potential for a fast, non-contact, full-field, and cost-effective technique which, in the case of adapting it to general endoscopes, also could be translated to further clinical applications. Prior to this, its real clinical impact should be proven in randomized clinical trials and in comparison to conventional clinical as well as competing techniques.
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Article Information
Application of laser speckle contrast imaging in laparoscopic surgery
Wido Heeman, Klaas Dijkstra, Christiaan Hoff, Sietze Koopal, Jean-Pierre Pierie, Hessel Bouma, and E. Christiaan Boerma
Biomed. Opt. Express 10(4) 2010-2019 (2019) View: Abstract | HTML | PDF