title: Advanced intraoperative imaging methods for laparoscopic anatomy navigation: an overview.
abstract: BACKGROUND
  Safety and efficiency are important topics in minimally invasive surgery. Apart from its advantages, laparoscopic surgery has the following drawbacks: two-dimensional imaging, challenging eye-hand coordination, and absence of tactile feedback. Enhanced imaging with earlier and clearer identification of essential tissue types can partly overcome these disadvantages. Research groups worldwide are investigating new technologies for image-guided surgery purposes. This review article gives an overview of current developments in surgical optical imaging for improved anatomic identification and physiologic tissue characterization during laparoscopic gastrointestinal surgery.
  
  
  METHODS
  A systematic literature search in the PubMed database was conducted. Eligible studies reported on any kind of novel optical imaging technique applied for anatomic identification or physiologic tissue characterization in laparoscopic gastrointestinal surgery. Gynecologic and urologic procedures also were included whenever vascular, nerve, ureter, or lymph node imaging was concerned.
  
  
  RESULTS
  Various surgical imaging techniques for enhanced intraoperative visualization of essential tissue types (i.e., blood vessel, bile duct, ureter, nerve, lymph node) and for tissue characterization purposes such as assessment of blood perfusion were identified. An overview of preclinical and clinical experiences is given as well as the potential added value for intraoperative anatomic localization and characterization during laparoscopy.
  
  
  CONCLUSIONS
  Implementation of new optical imaging methods during laparoscopic gastrointestinal surgery can improve intraoperative anatomy navigation. This may lead to increased patient safety (preventing iatrogenic functional tissue injury) and procedural efficiency (shorter operating time). Near-infrared fluorescence imaging seems to possess the greatest potential for implementation in clinical practice in the near future.
authors.affiliation: Department of Surgery, Maastricht University Medical Center, P.O. Box 5800, 6202, AZ Maastricht, The Netherlands. rutgermschols@hotmail.com
authors.forename: Rutger M
authors.initials: RM
authors.lastname: Schols
authors.forename: Nicole D
authors.initials: ND
authors.lastname: Bouvy
authors.forename: Ronald M
authors.initials: RM
authors.lastname: van Dam
authors.forename: Laurents P S
authors.initials: LP
authors.lastname: Stassen
mesh_terms: D003952:Diagnostic Imaging / Q000379:methods*; D013505:Digestive System Surgical Procedures / Q000379:methods* / Q000639:trends; D006801:Humans; D007430:Intraoperative Care / Q000379:methods / Q000639:trends; D010535:Laparoscopy / Q000379:methods* / Q000639:trends; D061848:Optical Imaging / Q000379:methods; D061088:Photoacoustic Techniques / Q000379:methods; D025321:Surgery, Computer-Assisted / Q000639:trends*; D041623:Tomography, Optical Coherence / Q000379:methods