Inadvertent injury to important anatomic structures including major vasculature is a significant risk in minimally invasive surgery that potentially requires conversion to open surgery and results in increased morbidity and mortality. The concern of unintended injury to important anatomic structures also potentially increases operative time, which in turn lengthens a patient’s exposure to anesthesia, and increases overall cost. Surgeons operating minimal-invasively currently do not have an easy-to-use, real-time device to aid in intraoperative identification of important anatomic structures that underlie tissue planes that must be carefully dissected in a stepwise layer-by-layer fasion to avoid injury to these structures. We demonstrate a simple method of freehand diffuse optical spectroscopy imaging (freeDOSi) for the potential of intra-operatively identifying significant anatomic structures including veins and arteries underlying the plane of dissection in minimally invasive surgery. An applicator-probe that can be adaptable to and detached from an 8mm instrument for laparoscopic or robotic-assisted DOS operation has been developed. The 10mm source-detector separation renders diffuse sampling of tissue heterogeneities a few millimeters deep. Consecutively acquired DOS spectra during freehand movement of the probe on tissue surface are displayed as a time-spectral image providing spatially-resolved identification of underlying structures presenting DOS heterogeneity. Identifications of vena cava and aorta underlying fat of up to 4mm were demonstrated repeatedly in multiple pigs in vivo.
Daqing Piao, Mohammad Ramadan, Aaron Park, Kenneth E. Bartels, and Sanjay Patel, "Intraoperative identification of underlying major venous and arterial vessels using freehand diffuse optical spectroscopy imaging (freeDOSi) for guiding minimally invasive surgery: an in vivo demonstration in a pig model (Conference Presentation)," Proc. SPIE 10468, Therapeutics and Diagnostics in Urology 2018, 1046809 (Presented at SPIE BiOS: January 27, 2018; Published: 14 March 2018); https://doi.org/10.1117/12.2284802.5751326541001.
Intraoperative identification of underlying major venous and arterial vessels using freehand diffuse optical spectroscopy imaging (freeDOSi) for guiding minimally invasive surgery: an in vivo demonstration in a pig model (Conference Presentation)
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