Doppler optical coherence tomography for energy seal evaluation and comparison to visual evaluation

Area of Science:

• Biomedical Optics
• Surgical Technology
• Medical Imaging

Background:

• Minimally invasive surgery relies on effective energy sealing devices.
• Objective evaluation of energy seal quality is critical but challenging, especially for small vessels.
• Current visual assessment methods for surgical seals have limitations.

Purpose of the Study:

• To introduce and evaluate Doppler optical coherence tomography (DOCT) as an objective method for assessing laser energy seals.
• To compare the efficacy of DOCT with traditional visual assessment by a neurovascular surgeon.

Main Methods:

• Thulium laser irradiation was applied to avian chorioallantoic membrane vessels.
• Vessels were subsequently scanned using optical coherence tomography (OCT).
• Outcomes were classified based on flow presence/absence, vessel diameter, and morphology, and compared to visual evaluations.

Main Results:

• DOCT classification identified seals (29%), ruptures (30%), partial seals (19%), and unaffected vessels (22%).
• Visual classification yielded 18% more seals than DOCT, indicating a significant difference in evaluation outcomes (p=0.01).
• Visual classification specificity was highly dependent on the accurate identification of partial seals (p<0.0001).

Conclusions:

• Doppler optical coherence tomography (DOCT) provides a more objective and accurate evaluation of laser energy seals compared to visual inspection.
• DOCT's high velocity resolution and morphological insights are invaluable for understanding the biological mechanisms of energy sealing.
• This method is indispensable for the precise evaluation of surgical energy seals, particularly in minimally invasive procedures.