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Jansen-Winkeln, B; Takoh, JP; Chalopin, C; Maktabi, M; Lyros, O; Sucher, R; Hoffmeister, A; Teich, N; Köhler, H; Gockel, I.
Hyperspectral Imaging: A New Intraoperative Tool for Pouch Assessment in Patients Undergoing Restorative Proctocolectomy.
Visc Med. 2021; 37(5):426-433
Doi: 10.1159/000515603
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Web of Science
PubMed
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- Co-authors Med Uni Graz
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Sucher Robert
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- Abstract:
- INTRODUCTION: Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) is a challenging operation. Especially the mobilization of the pouch into the pelvis can be complex. Adequate perfusion of the pouch is required for optimal healing and functioning. METHODS: With hyperspectral imaging (HSI) wavelengths between 500 and 1,000 nm can be analyzed in addition to visible light and by reflecting patterns. This intraoperative procedure is non-invasive, contact-free, and no contrast medium is needed. Fifteen patients undergoing IPAA were examined prospectively, and the pouch was evaluated by HSI intraoperatively. HSI was measured in standardized fashion at 4 defined locations of the J-pouch. Each measurement took about 10 s. The clinical postoperative course was assessed in all patients and correlated to the intraoperative HSI findings. RESULTS: Mean near-infrared perfusion and oxygenation of patients showed values ≥74% for all defined pouch areas, revealing good blood supply. Three minor anastomotic leaks were detected by standard pouchoscopy in the postoperative course, which could be treated conservatively with endosponge therapy. CONCLUSION: HSI values of perfusion and oxygenation of the IPAA were high. The leak rate is associated with redo procedures. This is reflected by the current literature and most likely related to the higher complexity of the revisional pouch operation. HSI has proved itself as a quick and effective new intraoperative tool to evaluate pouch perfusion objectively and quantitatively.
- Find related publications in this database (Keywords)
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Hyperspectral imaging
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Intraoperative imaging
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Proctocolectomy
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Ileal pouch-anal anastomosis
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Anastomotic leak