Our Summary

This research paper discusses the use of Near-Infrared (NIR) fluorescence imaging in assessing blood flow (perfusion) in the intestines during surgery. The technique uses a fluorescent dye called indocyanine green (ICG), which glows under NIR light and helps surgeons visualize blood flow in real time.

The study focuses on four patients who had surgery involving resection (removal) of the mesentery, a fold of tissue that supplies blood to the intestines. The researchers highlight the challenges in interpreting the fluorescent signals to accurately assess blood flow.

During the operation, the anesthesiologist injected ICG into the patients’ bloodstream. The surgeons then used a special camera to capture NIR images. These images were analyzed after the surgery to measure the intensity of fluorescence and related parameters.

The results showed that decisions made by surgeons based on NIR imaging led to different treatment strategies. In three of the four patients, the outcomes were excellent. However, one patient experienced a complication related to blood flow.

The researchers concluded that while NIR fluorescence imaging is a promising tool, interpreting the signals can be complex. They suggest that developing real-time methods of quantifying and standardizing the fluorescence signals could make it easier for surgeons to use this technique in the future.

FAQs

  1. What is Near-Infrared (NIR) fluorescence imaging and how is it used in bowel resection surgeries?
  2. What challenges did the researchers highlight in interpreting the fluorescent signals to assess blood flow?
  3. What were the results of the study and how did NIR fluorescence imaging impact the treatment strategies?

Doctor’s Tip

A helpful tip a doctor might tell a patient about bowel resection is to discuss the potential use of technologies such as Near-Infrared (NIR) fluorescence imaging during the surgery. This technique can help visualize blood flow in real time, which may assist in making decisions during the procedure and potentially improve outcomes. It is important for patients to be informed about the latest advancements in surgical technology and how they may benefit from them.

Suitable For

Patients who may be recommended for bowel resection surgery include those with:

  1. Intestinal blockages or strictures: Patients with severe blockages or narrowing in the intestines may require surgery to remove the affected portion.

  2. Inflammatory bowel disease (IBD): Patients with conditions such as Crohn’s disease or ulcerative colitis may need bowel resection to remove diseased portions of the intestines.

  3. Diverticulitis: Severe cases of diverticulitis, inflammation or infection of pouches in the colon, may require surgical removal of the affected area.

  4. Intestinal tumors: Patients with benign or malignant tumors in the intestines may need bowel resection to remove the tumors.

  5. Trauma or injury: Patients who have suffered severe trauma or injury to the intestines may require surgery to repair or remove damaged portions.

  6. Bowel ischemia: Patients with reduced blood flow to the intestines, which can lead to tissue damage, may require bowel resection to restore blood flow.

  7. Fistulas or abscesses: Patients with abnormal connections (fistulas) or pockets of infection (abscesses) in the intestines may need surgery to remove the affected areas.

Overall, bowel resection surgery may be recommended for patients with a variety of conditions affecting the intestines that cannot be managed with medication or other treatments.

Timeline

Before the bowel resection surgery, the patient likely undergoes pre-operative preparations such as blood tests, imaging studies, and consultations with the surgical team. The patient may also need to follow a special diet or take medications to prepare for the surgery.

During the surgery, the patient is placed under anesthesia and the surgeon performs the bowel resection procedure, which involves removing a portion of the intestine. In this particular study, the surgeon uses NIR fluorescence imaging with ICG to assess blood flow in the intestines during the operation.

After the surgery, the patient is closely monitored in the recovery room for any complications. The patient may need to stay in the hospital for a few days to recover before being discharged. The patient will also need to follow post-operative instructions, which may include pain management, wound care, and dietary restrictions.

In the long term, the patient may experience improvements in their symptoms if the surgery was successful in treating their underlying condition. However, they may also need to make lifestyle changes or follow-up appointments to monitor their recovery and overall health.

What to Ask Your Doctor

  1. What is the purpose of using NIR fluorescence imaging during bowel resection surgery?
  2. How does the use of ICG and NIR imaging help in assessing blood flow in the intestines?
  3. What are the potential benefits of using NIR imaging during bowel resection surgery?
  4. Are there any potential risks or limitations associated with using NIR fluorescence imaging in this context?
  5. How accurate is NIR imaging in assessing blood flow compared to traditional methods?
  6. How does the information obtained from NIR imaging impact decision-making during surgery?
  7. What are the implications of the study’s findings for future use of NIR imaging in bowel resection surgeries?
  8. How can the challenges in interpreting the fluorescent signals be addressed to improve the effectiveness of NIR imaging?
  9. Are there any specific criteria or conditions that make a patient a good candidate for NIR imaging during bowel resection surgery?
  10. Are there any additional precautions or considerations that patients should be aware of if NIR imaging is used during their surgery?

Reference

Authors: Meijer RPJ, van Manen L, Hartgrink HH, Burggraaf J, Gioux S, Vahrmeijer AL, Mieog JSD. Journal: J Biomed Opt. 2021 Jun;26(6):060501. doi: 10.1117/1.JBO.26.6.060501. PMID: 34109769