1 November 2010 Optical fiber probe spectroscopy for laparoscopic monitoring of tissue oxygenation during esophagectomies
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J. of Biomedical Optics, 15(6), 061712 (2010). doi:10.1117/1.3512149
Anastomotic complication is a major morbidity associated with esophagectomy. Gastric ischemia after conduit creation contributes to anastomotic complications, but a reliable method to assess oxygenation in the gastric conduit is lacking. We hypothesize that fiber optic spectroscopy can reliably assess conduit oxygenation, and that intraoperative gastric ischemia will correlate with the development of anastomotic complications. A simple optical fiber probe spectrometer is designed for nondestructive laparoscopic measurement of blood content and hemoglobin oxygen saturation in the stomach tissue microvasculature during human esophagectomies. In 22 patients, the probe measured the light transport in stomach tissue between two fibers spaced 3-mm apart (500- to 650-nm wavelength range). The stomach tissue site of measurement becomes the site of a gastroesophageal anastamosis following excision of the cancerous esophagus and surgical ligation of two of the three gastric arteries that provide blood perfusion to the anastamosis. Measurements are made at each of five steps throughout the surgery. The resting baseline saturation is 0.51±0.15 and decreases to 0.35±0.20 with ligation. Seven patients develop anastomotic complications, and a decreased saturation at either of the last two steps (completion of conduit and completion of anastamosis) is predictive of complication with a sensitivity of 0.71 when the specificity equaled 0.71.
Daniel S. Gareau, Frederic Truffer, Kyle Perry, Thai Pham, C. Kristian Enestvedt, James Dolan, John G. Hunter, Steven L. Jacques, "Optical fiber probe spectroscopy for laparoscopic monitoring of tissue oxygenation during esophagectomies," Journal of Biomedical Optics 15(6), 061712 (1 November 2010). https://doi.org/10.1117/1.3512149




Tissue optics


Optical fibers


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