Laparoscopic diagnostics of acute bowel ischemia using ultraviolet light and fluorescein dye: an experimental study.
OBJECTIVE
The aim of the study was to show the diagnostic potential of laparoscopy using fluorescein dye and ultraviolet light in acute bowel ischemia.


METHODS
The study involved 12 domestic pigs. Under general anesthesia, the peripheral branch of the superior mesenteric artery was embolized using polyvinyl-alcohol microparticles. Two hours after the embolization, optical filters were placed into the laparoscopic set to produce ultraviolet light. Fluorescein dye was given intravenously, and the bowel was inspected. Clips were placed on the border of the ischemia that was visualized with fluorescein. Resection of the ischemic part of the bowel and anastomosis of the viable parts were carried out using laparoscopic linear cutting staplers. After 24 hours, a laparoscopic second-look procedure was carried out to verify the viability of the anastomosis.


RESULTS
The method was in all cases able to recognize intestinal ischemia and reliably differentiate ischemic bowel segments from viable bowel. Microscopic analysis of the ischemic specimens showed beginning ischemic changes of the bowel tissues.


CONCLUSIONS
The method should be considered a valuable diagnostic procedure both for diagnostics of early stage of acute bowel ischemia and for second-look procedures.
Paral
Jiri
J
Department of Surgery, Faculty of Military Health Sciences, University of Defense, Hradec Kralove, Czech Republic. jiri.paral@seznam.cz
Jiri
Paral
P
Ferko
Alexander
A
Alexander
Ferko
F
Plodr
Michal
M
Michal
Plodr
P
Raupach
Jan
J
Jan
Raupach
R
Hadzi-Nikolov
Dimitar
D
Dimitar
Hadzi-Nikolov
HN
Dolezal
David
D
David
Dolezal
D
Chovanec
Vendelin
V
Vendelin
Chovanec
C
D000818:Animals; D004195:Disease Models, Animal; D004621:Embolization, Therapeutic; D005260:Female; D019793:Fluorescein; D005456:Fluorescent Dyes; D007422:Intestines / Q000098:blood supply*; D007511:Ischemia / Q000175:diagnosis*; D010535:Laparoscopy; D017538:Mesenteric Artery, Superior / Q000000981:diagnostic imaging; D011859:Radiography; D013552:Swine; D014466:Ultraviolet Rays
D005456:Fluorescent Dyes; D019793:Fluorescein