Related Experiment Video
Updated: Feb 20, 2026
Intestinal Stem Cell Isolation and Culture in a Porcine Model of Segmental Small Intestinal Ischemia
Published on: May 18, 2018
Feasibility of real-time intestinal bloodstream evaluation using probe-based confocal laser endomicroscopy in a
Tsuyoshi Takahashi1, Rie Nakatsuka1, Hisashi Hara1
1Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
Background:
Intestinal ischemia can lead to fatal complications if left unrecognized during surgery. The current techniques of intraoperative microvascular assessment remain subjective. Probe-based confocal laser endomicroscopy (pCLE) has the potential to objectively evaluate microvascular blood flow in real-time setting. The present study evaluated the technical feasibility of real-time intestinal bloodstream evaluation using pCLE in a porcine intestinal ischemia model.
Methods:
Seven pigs were used. The intestinal ischemia model was prepared by sequentially dividing the mesenteric blood vessels. The intestinal bloodstream was evaluated on its serosal surface using pCLE (Cellvizio 488 probe, Ultra Mini O) at every 1-cm segment from a vessel-preservation border (i.e., the cut end of the vessel). Images of the blood vessels and flow of red blood cells (RBCs) in each visualized vessel were semi-qualitatively assessed using a 3-scale scoring system. In addition, 25 surgeons blindly assessed the 10 movies recorded at 0, 1, 2, 3, and 5 cm from a vessel-preservation border using a 4-scale scoring system to confirm the consistency of the evaluation of the pCLE system.
Results:
Images of the blood vessels were successfully obtained from the cut end of the vessel to the segment 4 cm away. Good unidirectional flow of RBCs was observed from the cut end to the 2-cm segment, whereas the flow became bidirectional between 2 and 3 cm segments. Beyond 4 cm, no flow images were obtained. The specimen obtained from the segment beyond 4 cm showed remarkable mucosal color change, which was confirmed as a necrotic change histologically. The evaluations from the cut end of the vessel to the segment 1 cm away by surgeons were excellent or good and it was almost consistent.
Conclusions:
Real-time bloodstream evaluation using pCLE is feasible and potentially effective for predicting intestinal ischemia during surgery.
Insights
Probe-based confocal laser endomicroscopy (pCLE) offers a feasible method for real-time intestinal blood flow assessment. This technique shows potential for objectively detecting intraoperative intestinal ischemia during surgery.
Area of Science:
- Surgical innovation
- Medical imaging technology
- Gastrointestinal physiology
Background:
- Intraoperative intestinal ischemia poses significant risks if not detected.
- Current methods for assessing microvascular blood flow during surgery are subjective.
- Objective, real-time assessment tools are needed to improve patient outcomes.
Purpose of the Study:
- To evaluate the technical feasibility of using probe-based confocal laser endomicroscopy (pCLE) for real-time intestinal blood flow assessment.
- To determine if pCLE can objectively detect changes indicative of intestinal ischemia in a porcine model.
Main Methods:
- A porcine model of intestinal ischemia was created by ligating mesenteric blood vessels.
- pCLE was used to visualize blood flow in red blood cells (RBCs) along segments of the intestine.
- Blood flow patterns were semi-quantitatively scored, and surgeon assessments of recorded videos were performed.
Main Results:
- pCLE successfully visualized blood flow up to 4 cm from the ligation site.
- Unidirectional RBC flow was observed up to 2 cm, becoming bidirectional between 2-3 cm.
- Histological analysis confirmed necrosis beyond 4 cm, correlating with the absence of pCLE flow images.
Conclusions:
- Real-time intestinal bloodstream evaluation using pCLE is technically feasible.
- pCLE demonstrates potential as an effective tool for predicting intraoperative intestinal ischemia.
- Objective microvascular assessment with pCLE could enhance surgical safety and patient outcomes.
