Skip to main content
SpringerLink
Log in

Laparoscopic evaluation of intestinal ischemia using fluorescein and ultraviolet light in a porcine model

  • Original article
  • Published:
Surgical Endoscopy And Other Interventional Techniques Aims and scope Submit manuscript

Abstract

Background: The laparoscopic use of fluorescein and ultraviolet light may be a useful diagnostic tool that potentially could reduce the time until diagnosis and the subsequent mortality of mesenteric ischemia. Methods: Eight pigs were subjected to a pneumoperitoneum pressure of 7 mmHg, and another eight pigs were exposed to a pressure of 14 mmHg. A segment of small bowel was devascularized. Two filters were used to create ultraviolet light. Pigs from each pressure group were given various intravenous fluorescein doses. The ischemic segment of the small intestine and other structures were inspected laparoscopically with the filters attached. A videotape was evaluated by resident and attending surgeons. Results: Ischemic bowel was seen as a darkened silhouette against the viable fluorescent tissue. Overall, the results show that the use of ultraviolet light and fluorescence in the laparoscopic model is adequate for allowing the identification of ischemic bowel. Conclusions: The laparoscopic use of ultraviolet light combined with intravenous fluorescein dye is an effective diagnostic tool for evaluating mesenteric ischemia in pigs.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Figure 1
Figure 2

Similar content being viewed by others

References

  1. J Ballard W Stone J Hallett P Pairolero K Cherry (1993) ArticleTitleA critical analysis of adjuvant techniques used to assess bowel viability in acute mesenteric ischemia. Am Surg 59 309–311 Occurrence Handle1:STN:280:ByyB2MnjslA%3D Occurrence Handle8489100

    CAS  PubMed  Google Scholar 

  2. G Bulkley G Zuidema S Hamilton C O’Mara P Klacsmann S Horn (1981) ArticleTitleIntraoperative determination of small intestinal viability following ischemic injury. Ann Surg 193 628–637

    Google Scholar 

  3. D Dyess B Bruner C Donnell J Ferrara R Powell (1991) ArticleTitleIntraoperative evaluation of intestinal ischemia: a comparison of methods. South Med J 84 966–974 Occurrence Handle1:STN:280:By6A2M3msVE%3D Occurrence Handle1882273

    CAS  PubMed  Google Scholar 

  4. J Eldrup-Jorgensen R Hawkins C Brendenberg (1997) ArticleTitleAbdominal vascular catastrophes. Surg Clin North Am 77 1305–1320 Occurrence Handle1:STN:280:DyaK1c%2Fptleluw%3D%3D Occurrence Handle9431341

    CAS  PubMed  Google Scholar 

  5. S Galandiuk V Fazio R Petras (1988) ArticleTitleFluorescein endoscopy. Dis Colon Rectum. 31 848–853 Occurrence Handle1:STN:280:BiaD3s%2FhtFM%3D Occurrence Handle3180956

    CAS  PubMed  Google Scholar 

  6. T Gorey (1980) ArticleTitleThe recovery of intestine after ischemic injury. Br J Surg 67 699–702 Occurrence Handle1:STN:280:Bi6D2c%2Fms1w%3D Occurrence Handle7427023

    CAS  PubMed  Google Scholar 

  7. P Horgan T Gorey (1992) ArticleTitleOperative assessment of intestinal viability. Surg Clin North Am 72 143–154 Occurrence Handle1:STN:280:By2C3Mnis1M%3D Occurrence Handle1731381

    CAS  PubMed  Google Scholar 

  8. T Iberti B Salky D Onofrey (1989) ArticleTitleUse of bedside laparoscopy to identify intestinal ischemia in postoperative cases of aortic reconstruction. Surgery 105 686–688 Occurrence Handle1:STN:280:BiaB3czntFY%3D Occurrence Handle2523091

    CAS  PubMed  Google Scholar 

  9. R Kaleya S Boley (1992) ArticleTitleAcute mesenteric ischemia: an aggressive diagnostic and therapeutic approach. 1991 Roussel lecture. Can J Surg 35 613–623 Occurrence Handle1:STN:280:ByyD1M3gtlc%3D Occurrence Handle1458387

    CAS  PubMed  Google Scholar 

  10. D Kam D Scheeres (1993) ArticleTitleFluorescein-assisted laparoscopy in the identification of arterial mesenteric ishemia. Surg Endosc 7 75–78 Occurrence Handle1:STN:280:ByyB3cnitVc%3D Occurrence Handle8456372

    CAS  PubMed  Google Scholar 

  11. B Kurland L Brandt H Delany (1992) ArticleTitleDiagnostic tests for intestinal ischemia. Surg Clin North Am 72 85–101 Occurrence Handle1:STN:280:By2C3MnislM%3D Occurrence Handle1731391

    CAS  PubMed  Google Scholar 

  12. K Lange L Boyd (1942) ArticleTitleThe use of fluorescein to determine the adequacy of the circulation. Med Clin North Am 26 943–952

    Google Scholar 

  13. N Mamode I Pickford P Leiberman (1999) ArticleTitleFailure to improve outcome in acute mesenteric ischemia: seven-year review. Eur J Surg 165 203–208 Occurrence Handle10.1080/110241599750007054 Occurrence Handle1:STN:280:DyaK1M3kvVCgtg%3D%3D Occurrence Handle10231652

    Article  CAS  PubMed  Google Scholar 

  14. A Mann V Fazio F Lucas (1982) ArticleTitleA comparative study of the use of fluorescein and the Doppler device in the determination of intestinal viability. Surg Gynecol Obstet 154 53–55 Occurrence Handle1:STN:280:Bi2D1crgslI%3D Occurrence Handle6976009

    CAS  PubMed  Google Scholar 

  15. R Orlando K Crowell (1997) ArticleTitleLaparoscopy in the critically ill. Surg Endosc 11 1072–1074 Occurrence Handle10.1007/s004649900532 Occurrence Handle9348376

    Article  PubMed  Google Scholar 

  16. E Paes J Vollmar S Hutschenreiter M Schoenberg R Kubel E Scholzel (1988) ArticleTitleMesenteric infarct: new aspects of diagnosis and therapy. Chirurg 59 828–835 Occurrence Handle1:STN:280:BiaC28bptVE%3D Occurrence Handle3234093

    CAS  PubMed  Google Scholar 

  17. W Pearce D Jones G Warren E Bartle T Whitehill R Rutherford (1987) ArticleTitleThe use of infrared photoplethysmography in identifying early intestinal ischemia. Arch Surg 122 308–310 Occurrence Handle1:STN:280:BiiC2MrpsVA%3D Occurrence Handle3827570

    CAS  PubMed  Google Scholar 

  18. C Stolar J Randolph (1978) ArticleTitleEvaluation of ischemic bowel viability with a fluorescent technique. J Pediatr Surg 13 221–225 Occurrence Handle1:STN:280:CSeB38%2FhtFQ%3D Occurrence Handle671186

    CAS  PubMed  Google Scholar 

  19. J Windsor M Bonham M Rumball (1997) ArticleTitleSplanchnic mucosal ischemia: an unrecognized consequence of routine pneumoperitoneum. Surg Laparosc Endosc 7 480–482 Occurrence Handle10.1097/00019509-199712000-00010 Occurrence Handle1:STN:280:DyaK1c%2FpvFCluw%3D%3D Occurrence Handle9438631

    Article  CAS  PubMed  Google Scholar 

  20. G Zamir P Reissmann (1998) ArticleTitleDiagnostic laparoscopy in mesenteric ischemia. Surg Endosc 12 390–393 Occurrence Handle10.1007/s004649900688 Occurrence Handle1:STN:280:DyaK1c3ktVKitw%3D%3D Occurrence Handle9569355

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

We thank Sandra Bell McGinty, PhD, for her editorial help, statistical expertise, and endless support, Laurel Omert, MD, for her editing assistance, and Ms. Susan Gardner for her assistance in preparing the text.

Author information

Authors and Affiliations

  1. Department of Surgery, Allegheny General Hospital, West Penn Allegheny Health System, 320 E. North Avenue, Pittsburgh, PA 15212, USA

    J. J. McGinty Jr & N. Hogle

  2. Department of Surgery, New York Presbyterian Hospital, Weill Medical College of Cornell University, 525 E. 68th Street, New York, NY 10021, USA

    D. L Fowler

Authors
  1. J. J. McGinty Jr
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. N. Hogle
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. D. L Fowler
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

McGinty, J., Hogle, N. & Fowler, D. Laparoscopic evaluation of intestinal ischemia using fluorescein and ultraviolet light in a porcine model . Surg Endosc 17, 1140–1143 (2003). https://doi.org/10.1007/s00464-001-8255-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-001-8255-y

Keywords

Search

Navigation