Optical fiber probe spectroscopy for laparoscopic monitoring of tissue oxygenation during esophagectomies

Daniel S. Gareau, Frederic Truffer, Kyle A. Perry, Thai H. Pham, C. Kristian Enestvedt, James P. Dolan, John G. Hunter, Steven L. Jacques

Research output: Contribution to journalArticle

10 Scopus citations

Abstract

Anastomotic complication is a major morbidity associated with esophagectomy. Gastric ischemia after conduit creation contributes to anastomotic complications, but a reliable method to assess oxygenation in the gastric conduit is lacking. We hypothesize that fiber optic spectroscopy can reliably assess conduit oxygenation, and that intraoperative gastric ischemia will correlate with the development of anastomotic complications. A simple optical fiber probe spectrometer is designed for nondestructive laparoscopic measurement of blood content and hemoglobin oxygen saturation in the stomach tissue microvasculature during human esophagectomies. In 22 patients, the probe measured the light transport in stomach tissue between two fibers spaced 3-mm apart (500- to 650-nm wavelength range). The stomach tissue site of measurement becomes the site of a gastroesophageal anastamosis following excision of the cancerous esophagus and surgical ligation of two of the three gastric arteries that provide blood perfusion to the anastamosis. Measurements are made at each of five steps throughout the surgery. The resting baseline saturation is 0.51±0.15 and decreases to 0.35±0.20 with ligation. Seven patients develop anastomotic complications, and a decreased saturation at either of the last two steps (completion of conduit and completion of anastamosis) is predictive of complication with a sensitivity of 0.71 when the specificity equaled 0.71.

Original languageEnglish (US)
Article number061712
JournalJournal of Biomedical Optics
Volume15
Issue number6
DOIs
Publication statusPublished - Nov 2010

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Keywords

  • diffuse reflectance spectroscopy
  • optical fibers
  • oxygen saturation
  • surgery

ASJC Scopus subject areas

  • Biomedical Engineering
  • Biomaterials
  • Electronic, Optical and Magnetic Materials
  • Atomic and Molecular Physics, and Optics

Cite this

Gareau, D. S., Truffer, F., Perry, K. A., Pham, T. H., Enestvedt, C. K., Dolan, J. P., ... Jacques, S. L. (2010). Optical fiber probe spectroscopy for laparoscopic monitoring of tissue oxygenation during esophagectomies. Journal of Biomedical Optics, 15(6), [061712]. https://doi.org/10.1117/1.3512149