Laparoscopic Diagnostics of Acute Bowel Ischemia Using Ultraviolet Light and Fluorescein Dye: An Experimental Study

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PurposeThe aim of the study was to show the diagnostic potential of laparoscopy using fluorescein dye and ultraviolet light in acute bowel ischemia.Materials and MethodsThe 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.ResultsThe 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.ConclusionsThe method should be considered a valuable diagnostic procedure both for diagnostics of early stage of acute bowel ischemia and for second-look procedures.

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