Emergency laparoscopy. Technical support for the laparoscopic diagnosis of intestinal ischemia.
BACKGROUND
Laparoscopic diagnosis of intestinal ischemia is difficult. Dark-colored bowels are not a reliable indicator for infarction, because there is no correlation between color and oxygenation. The same picture is produced by intraluminal blood or feces. False diagnoses are described.


METHODS
We analyzed various techniques for assessing intestinal oxygenation and perfusion to support laparoscopic diagnosis. In this study laparoscopy was performed on eight pigs. A 10-cm segment of intestine was fixed to the abdominal wall and rendered ischemic. Measurements of the ischemic segment and normal intestine were taken using laser-Doppler, Doppler ultrasound, spectrophotometer, and pulse oximeter. Doppler ultrasound and pulse oximetry were unsuitable in our model, as was laser-Doppler flowmetry.


RESULTS
Only the spectrophotometer proved a highly sensitive means of assessing bowel oxygenation.


CONCLUSIONS
This method provides the desired additional information about intestinal oxygenation, thus helping to interpret the laparoscopic picture of dark bowels.
Matern
U
U
Department of General Surgery, University Hospital, Freiburg, Germany.
Haberstroh
J
J
el Saman
A
A
Pauly
E
E
Salm
R
R
Farthmann
E H
EH
D000818:Animals; D007422:Intestines / Q000098:blood supply*; D007511:Ischemia / Q000175:diagnosis*; D010535:Laparoscopy; D010092:Oximetry; D012680:Sensitivity and Specificity; D013053:Spectrophotometry; D013552:Swine