Predicting Bowel Viability With Laser Speckle Contrast Imaging: A Quantitative Assessment and Survival Study in Rats

Accurate intraoperative determination of bowel viability remains unresolved, as current assessments are subjective and dye-based methods cannot capture reperfusion dynamics. Laser speckle contrast imaging (LSCI) offers a dye-free, real-time, and repeatable approach for quantifying tissue perfusion. We conducted a two-phase rat study to establish a quantitative threshold and validate its predictive value for ischemic recovery. In Phase 1 (n = 6), ischemia (30-180 min) was induced, and LSCI ratios at 60 min after reperfusion were analyzed. A ratio ≥ 0.8 defined viability, whereas < 0.5 indicated irreversible damage. In Phase 2 (n = 4), this threshold was prospectively tested in a survival model. Segments subjected to ≤ 90 min ischemia recovered, the 120-min case showed delayed but complete recovery, while 150 min led to necrosis. This is the first experimental demonstration that LSCI can predict bowel recovery after reperfusion, providing a novel, objective framework for intraoperative viability assessment.