title: Emergency laparoscopy. Technical support for the laparoscopic diagnosis of intestinal ischemia.
abstract: 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.
authors.affiliation: Department of General Surgery, University Hospital, Freiburg, Germany.
authors.forename: U
authors.initials: U
authors.lastname: Matern
authors.forename: J
authors.initials: J
authors.lastname: Haberstroh
authors.forename: A
authors.initials: A
authors.lastname: el Saman
authors.forename: E
authors.initials: E
authors.lastname: Pauly
authors.forename: R
authors.initials: R
authors.lastname: Salm
authors.forename: E H
authors.initials: EH
authors.lastname: Farthmann
mesh_terms: D000818:Animals; D007422:Intestines / Q000098:blood supply*; D007511:Ischemia / Q000175:diagnosis*; D010535:Laparoscopy; D010092:Oximetry; D012680:Sensitivity and Specificity; D013053:Spectrophotometry; D013552:Swine