title: Laparoscopic infrared imaging--the future vascular map.
abstract: OBJECTIVE
  One of the most significant limitations of laparoscopic surgery is the inability to achieve tactile assessment of structures during surgical dissection. Because blood vessels are naturally warmer than their surroundings, infrared (IR) detection can be highly effective in identifying and mapping out their course. In recent years, IR detection has been used successfully for this purpose in open surgery. Nevertheless, this technology has to be yet employed in laparoscopic surgery, where its contribution would be greatest.
  
  
  METHODS
  We performed a feasibility study using this technology on live porcine models. After insertion of IR detectors into the insufflated abdomen, we performed a series of laparoscopic procedures. During these operations we evaluated the ability of the IR detector to identify blood vessels as well as the effects of local and systemic changes in temperature.
  
  
  RESULTS
  The IR detector successfully identified concealed blood vessels as well as acute bleeding. Cool lavage and insufflation with room-temperature CO(2) accentuated IR detection of blood vessels, whereas warm CO(2) and systemic temperature changes did not affect detection. Additionally, localized heating of tissue on the operative field using electrocautery did not interfere with IR sensitivity.
  
  
  CONCLUSIONS
  Laparoscopic IR imaging is a feasible method of blood vessel detection in laparoscopic procedures. Use of IR blood vessel detection in laparoscopy has a potential to enable safer surgery and reduce operative time. Fusion of IR imaging with the standard laparoscopic view is currently being developed to allow real-time vessel mapping during laparoscopic procedures.
authors.affiliation: Department of General Surgery, Hadassah Hebrew University Medical Center, Jerusalem, Israel. noams@hadassah.org.il
authors.forename: Noam
authors.initials: N
authors.lastname: Shussman
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Abu Gazala
authors.forename: Avraham
authors.initials: A
authors.lastname: Schlager
authors.forename: Ram
authors.initials: R
authors.lastname: Elazary
authors.forename: Abed
authors.initials: A
authors.lastname: Khalaileh
authors.forename: Gideon
authors.initials: G
authors.lastname: Zamir
authors.forename: David
authors.initials: D
authors.lastname: Kushnir
authors.forename: Avraham I
authors.initials: AI
authors.lastname: Rivkind
authors.forename: Yoav
authors.initials: Y
authors.lastname: Mintz
mesh_terms: D000818:Animals; D001808:Blood Vessels / Q000033:anatomy & histology*; D005240:Feasibility Studies; D007259:Infrared Rays; D010535:Laparoscopy / Q000379:methods*; D013552:Swine