Real-time Quantification of Bowel Perfusion using Laparoscopic Laser Speckle Contrast Imaging (LSCI) in a Porcine Model

Real-time Quantification of Bowel Perfusion using Laparoscopic Laser Speckle Contrast Imaging (LSCI) in a Porcine Model | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Real-time Quantification of Bowel Perfusion using Laparoscopic Laser Speckle Contrast Imaging (LSCI) in a Porcine Model Saloni Mehrotra, Yao Liu, Chibueze Nwaiwu, Vasiliy E Buharin, and 4 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-2763284/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 31 Aug, 2023 Read the published version in BMC Surgery → Version 1 posted 11 You are reading this latest preprint version Abstract Background/Purpose Real-time quantification of tissue perfusion can improve intraoperative surgical decision making. Here we demonstrate the utility of Laser Speckle Contrast Imaging as an intra-operative tool that quantifies real-time regional differences in intestinal perfusion and distinguishes ischemic changes resulting from arterial/venous obstruction. Methods Porcine models (n = 3) consisted of selectively devascularized small bowel loops that were used to measure the perfusion responses under conditions of control/no vascular occlusion, arterial inflow occlusion, and venous outflow occlusion using laser speckle imaging and indocyanine green fluoroscopy. Laser Speckle was also used to assess perfusion differences between small bowel antimesenteric-antimesenteric and mesenteric-mesenteric anastomoses. Perfusion quantification was measured in relative perfusion units calculated from the laser speckle perfusion heatmap. Results Laser Speckle distinguished between visually identified perfused, watershed, and ischemic intestinal segments with both color heatmap and quantification (p < .00001). It detected a continuous gradient of relative intestinal perfusion as a function of distance from the stapled ischemic bowel edge. Strong positive linear correlation between relative perfusion units and changes in mean arterial pressure resulting from both arterial (R 2 = .96/.79) and venous pressure changes (R 2 = .86/.96) was observed. Furthermore, Laser Speckle showed that the antimesenteric anastomosis had a higher perfusion than mesenteric anastomosis (p < 0.01). Conclusions Laser Speckle Contrast Imaging provides objective, quantifiable tissue perfusion information in both color heatmap and relative numerical units. Laser Speckle can detect spatial/temporal differences in perfusion between antimesenteric and mesenteric borders of a bowel segment and precisely detect perfusion changes induced by progressive arterial/venous occlusions in real-time. bowel perfusion laser speckle contrast imaging perfusion quantification anastomotic leak indocyanine green Full Text Additional Declarations Competing interest reported. Drs. Mehrotra and Nwaiwu were former research residents working with Activ Surgical. Dr. Liu is a current research resident and employee of Activ Surgical. Drs. Buharin, Stolyarov, and Kim are fully employed by Activ Surgical. Dr. Schwaitzberg is on the scientific advisory board of Activ Surgical, Human Xtensions, New View Surgical, HAI technology, Levitra magnetics and Arch Therapeutics. Dr. Kalady is on the scientific advisory board of Activ Surgical, past consultant for Freenome and Biom ‘up. Cite Share Download PDF Status: Published Journal Publication published 31 Aug, 2023 Read the published version in BMC Surgery → Version 1 posted Editorial decision: Major revision 28 Jun, 2023 Reviews received at journal 26 Jun, 2023 Reviews received at journal 12 Jun, 2023 Reviews received at journal 05 Jun, 2023 Reviewers agreed at journal 05 Jun, 2023 Reviewers agreed at journal 01 Jun, 2023 Reviewers invited by journal 29 May, 2023 Editor assigned by journal 24 May, 2023 Editor invited by journal 06 May, 2023 Submission checks completed at journal 06 May, 2023 First submitted to journal 31 Mar, 2023 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-2763284","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":197905077,"identity":"87f2a66b-8a0e-4ef0-abb0-92edd9c9ebce","order_by":0,"name":"Saloni Mehrotra","email":"","orcid":"","institution":"University at Buffalo","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Saloni","middleName":"","lastName":"Mehrotra","suffix":""},{"id":197905081,"identity":"e5e75fc9-8c70-4a94-8598-4ce294967092","order_by":1,"name":"Yao Liu","email":"","orcid":"","institution":"Brown University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Yao","middleName":"","lastName":"Liu","suffix":""},{"id":197905086,"identity":"093e9104-468e-4f97-b3f3-db57752cd3cc","order_by":2,"name":"Chibueze Nwaiwu","email":"","orcid":"","institution":"Brown University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Chibueze","middleName":"","lastName":"Nwaiwu","suffix":""},{"id":197905087,"identity":"f79f0ad6-96d0-4a6e-b38d-2886126f1ce8","order_by":3,"name":"Vasiliy E Buharin","email":"","orcid":"","institution":"Activ Surgical Inc","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Vasiliy","middleName":"E","lastName":"Buharin","suffix":""},{"id":197905090,"identity":"7b21a4a1-0500-4e2d-a6c5-98bedfeb0d81","order_by":4,"name":"Roman Stolyarov","email":"","orcid":"","institution":"Activ Surgical Inc","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Roman","middleName":"","lastName":"Stolyarov","suffix":""},{"id":197905091,"identity":"59f521bf-016b-49d3-97ae-733a62ea013d","order_by":5,"name":"Steven D Schwaitzberg","email":"","orcid":"","institution":"University at Buffalo","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Steven","middleName":"D","lastName":"Schwaitzberg","suffix":""},{"id":197905093,"identity":"243fe0af-31df-4201-aa64-9ef124efa179","order_by":6,"name":"Matthew F Kalady","email":"","orcid":"","institution":"The Ohio State University Wexner Medical Center","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Matthew","middleName":"F","lastName":"Kalady","suffix":""},{"id":197905095,"identity":"2787197e-634d-4960-b080-3ab328149743","order_by":7,"name":"Peter Kim","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA8UlEQVRIiWNgGAWjYBAC+xmJDQwfgAw2CF+CgYGdgBaDGwcbGGcAlSK0MBPScrOBgZkHrBQGCGq5zdy62abGro5PIv2ZdMUvC3n+ZgbGDx9z8PhlHmPb7ZxjyRJsEjlmkmf7JAxnHGZglpy5DY8tciAtbAck2HjOsEk29kgkMBxmYGPmxadFGqjF4h9Iy/FnYC3yBLVINrbdZmwDamFvMJNs+CGRYEBQi8TBtpu9fcmSbew9xpaNDRKGGw8zNuP3CzCgbvz4Zscv38z+8GbDnzp5uePNBz98xKMFFTC2gckGYtWDwB9SFI+CUTAKRsFIAQD8YEy42kA8QwAAAABJRU5ErkJggg==","orcid":"","institution":"Brown University","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Peter","middleName":"","lastName":"Kim","suffix":""}],"badges":[],"createdAt":"2023-03-31 23:14:12","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-2763284/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-2763284/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12893-023-02161-w","type":"published","date":"2023-08-31T15:10:12+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":42782212,"identity":"c45e8aca-a046-400a-bebd-e78817392802","added_by":"auto","created_at":"2023-09-07 15:16:24","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1336682,"visible":true,"origin":"","legend":"","description":"","filename":"BMCSurgeryManuscript05.04.pdf","url":"https://assets-eu.researchsquare.com/files/rs-2763284/v1_covered_e04635bb-c03e-42e9-8aaa-270c8bc334ab.pdf"}],"financialInterests":"Competing interest reported. 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Here we demonstrate the utility of Laser Speckle Contrast Imaging as an intra-operative tool that quantifies real-time regional differences in intestinal perfusion and distinguishes ischemic changes resulting from arterial/venous obstruction.\u003c/p\u003e\u003cp\u003e\u003cb\u003eMethods\u003c/b\u003e\u003c/p\u003e \u003cp\u003ePorcine models (n\u0026thinsp;=\u0026thinsp;3) consisted of selectively devascularized small bowel loops that were used to measure the perfusion responses under conditions of control/no vascular occlusion, arterial inflow occlusion, and venous outflow occlusion using laser speckle imaging and indocyanine green fluoroscopy. Laser Speckle was also used to assess perfusion differences between small bowel antimesenteric-antimesenteric and mesenteric-mesenteric anastomoses. Perfusion quantification was measured in relative perfusion units calculated from the laser speckle perfusion heatmap.\u003c/p\u003e\u003cp\u003e\u003cb\u003eResults\u003c/b\u003e\u003c/p\u003e \u003cp\u003eLaser Speckle distinguished between visually identified perfused, watershed, and ischemic intestinal segments with both color heatmap and quantification (p\u0026thinsp;\u0026lt;\u0026thinsp;.00001). It detected a continuous gradient of relative intestinal perfusion as a function of distance from the stapled ischemic bowel edge. Strong positive linear correlation between relative perfusion units and changes in mean arterial pressure resulting from both arterial (R\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;.96/.79) and venous pressure changes (R\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;.86/.96) was observed. Furthermore, Laser Speckle showed that the antimesenteric anastomosis had a higher perfusion than mesenteric anastomosis (p\u0026thinsp;\u0026lt;\u0026thinsp;0.01).\u003c/p\u003e\u003cp\u003e\u003cb\u003eConclusions\u003c/b\u003e\u003c/p\u003e \u003cp\u003eLaser Speckle Contrast Imaging provides objective, quantifiable tissue perfusion information in both color heatmap and relative numerical units. Laser Speckle can detect spatial/temporal differences in perfusion between antimesenteric and mesenteric borders of a bowel segment and precisely detect perfusion changes induced by progressive arterial/venous occlusions in real-time.\u003c/p\u003e","manuscriptTitle":"Real-time Quantification of Bowel Perfusion using Laparoscopic Laser Speckle Contrast Imaging (LSCI) in a Porcine Model","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2023-05-09 18:16:07","doi":"10.21203/rs.3.rs-2763284/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Major revision","date":"2023-06-28T12:25:17+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2023-06-26T10:30:22+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2023-06-12T11:12:39+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2023-06-05T13:28:30+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"48b93eaf-5319-4f69-b430-9d2701142f00","date":"2023-06-05T13:05:53+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"b2609ddb-74ad-46f1-8a7a-6fce9e1286c3","date":"2023-06-01T09:04:10+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2023-05-29T17:38:32+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2023-05-24T16:27:43+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2023-05-06T10:32:28+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2023-05-06T10:27:15+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Surgery","date":"2023-03-31T23:04:11+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-surgery","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bsur","sideBox":"Learn more about [BMC Surgery](http://bmcsurg.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bsur/default.aspx","title":"BMC Surgery","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"5e2ddf42-36fe-4cfa-9563-b57c9c778328","owner":[],"postedDate":"May 9th, 2023","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2023-09-07T15:14:16+00:00","versionOfRecord":{"articleIdentity":"rs-2763284","link":"https://doi.org/10.1186/s12893-023-02161-w","journal":{"identity":"bmc-surgery","isVorOnly":false,"title":"BMC Surgery"},"publishedOn":"2023-08-31 15:10:12","publishedOnDateReadable":"August 31st, 2023"},"versionCreatedAt":"2023-05-09 18:16:07","video":"","vorDoi":"10.1186/s12893-023-02161-w","vorDoiUrl":"https://doi.org/10.1186/s12893-023-02161-w","workflowStages":[]},"version":"v1","identity":"rs-2763284","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-2763284","identity":"rs-2763284","version":["v1"]},"buildId":"369fNeqWncA4NS6XSWjrt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}