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Erschienen in: International Journal of Colorectal Disease 4/2019

02.02.2019 | Original Article

Determination of the transection margin during colorectal resection with hyperspectral imaging (HSI)

verfasst von: Boris Jansen-Winkeln, N. Holfert, H. Köhler, Y. Moulla, J. P. Takoh, S. M. Rabe, M. Mehdorn, M. Barberio, C. Chalopin, T. Neumuth, I. Gockel

Erschienen in: International Journal of Colorectal Disease | Ausgabe 4/2019

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Abstract

Purpose

This study evaluated the use of hyperspectral imaging for the determination of the resection margin during colorectal resections instead of clinical macroscopic assessment.

Methods

The used hyperspectral camera is able to record light spectra from 500 to 1000 nm and provides information about physiologic parameters of the recorded tissue area intraoperatively (e.g., tissue oxygenation and perfusion). We performed an open-label, single-arm, and non-randomized intervention clinical trial to compare clinical assessment and hyperspectral measurement to define the resection margin in 24 patients before and after separation of the marginal artery over 15 min; HSI was performed each minute to assess the parameters mentioned above.

Results

The false color images calculated from the hyperspectral data visualized the margin of perfusion in 20 out of 24 patients precisely. In the other four patients, the perfusion difference could be displayed with additional evaluation software. In all cases, there was a deviation between the transection line planed by the surgeon and the border line visualized by HSI (median 1 mm; range − 13 to 13 mm).
Tissue perfusion dropped up to 12% within the first 10 mm distal to the border line. Therefore, the resection area was corrected proximally in five cases due to HSI record. The biggest drop in perfusion took place in less than 2 min after devascularization.

Conclusion

Determination of the resection margin by HSI provides the surgeon with an objective decision aid for assessment of the best possible perfusion and ideal anastomotic area in colorectal surgery.
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Metadaten
Titel
Determination of the transection margin during colorectal resection with hyperspectral imaging (HSI)
verfasst von
Boris Jansen-Winkeln
N. Holfert
H. Köhler
Y. Moulla
J. P. Takoh
S. M. Rabe
M. Mehdorn
M. Barberio
C. Chalopin
T. Neumuth
I. Gockel
Publikationsdatum
02.02.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
International Journal of Colorectal Disease / Ausgabe 4/2019
Print ISSN: 0179-1958
Elektronische ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-019-03250-0

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