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Border Line Definition Using Hyperspectral Imaging in Colorectal Resections.

Boris Jansen-Winkeln1,2, Michelle Dvorak1, Hannes Köhler3

  • 1Department of Visceral, Transplant, Thoracic, and Vascular Surgery, University Hospital of Leipzig AöR, 04103 Leipzig, Germany.

Cancers
|March 10, 2022
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Summary

Hyperspectral imaging (HSI) offers a safe and reproducible method to quantify tissue oxygenation during colorectal surgery. This technology can guide surgical decisions, potentially reducing anastomotic leaks.

Keywords:
anastomotic leak (AL)colorectal resectionhyperspectral imaging (HSI)intraoperative imagingtissue oxygenationtissue perfusion

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Area of Science:

  • Surgical Innovation
  • Medical Imaging Technology
  • Gastrointestinal Surgery

Background:

  • Anastomotic leak (AL) is a significant complication of colorectal surgery, often linked to intraoperative perfusion deficits.
  • Current methods for assessing tissue perfusion during surgery lack objective and quantitative data.
  • Hyperspectral imaging (HSI) presents a potential solution for real-time, quantitative perfusion assessment.

Purpose of the Study:

  • To evaluate the capability of hyperspectral imaging (HSI) to quantitatively assess intraoperative tissue oxygenation.
  • To determine if HSI can provide objective guidance for determining optimal resection margins in colorectal surgery.

Main Methods:

  • 115 patients undergoing colorectal resections were included in the study.
  • A compact HSI camera was used to image the bowel resection line before anastomosis formation.
  • HSI provided instantaneous, quantitative perfusion assessment of the bowel surface.

Main Results:

  • HSI visualized a clear demarcation line of perfusion within minutes of marginal artery transection in most patients.
  • The HSI-determined transection line aligned with the clinical assessment in 55.2% of patients.
  • HSI identified discrepancies in 44.8% of cases, revealing areas of insufficient perfusion or guiding adjustments to the resection line, and detected four previously unrecognized marginal artery lesions.

Conclusions:

  • Intraoperative HSI is a safe, reproducible technique that integrates seamlessly into surgical workflows.
  • HSI accurately quantifies bowel surface perfusion, offering objective data for surgical decision-making.
  • HSI holds promise as an intraoperative tool to enhance surgical guidance and potentially prevent postoperative complications like anastomotic leaks.