激光散斑对比成像 (LSCI) 在机器人辅助手术 (RAS) 中显示实时组织灌注/血流的效用...

背景
激光散斑对比成像 (LSCI) 在机器人辅助手术 (RAS) 和腹腔镜手术中检测实时组织灌注的效用和可用性尚不清楚。 LSCI 通过捕捉相干激光对红细胞的干扰，显示实时组织血流的彩色热图。 LSCI 在灌注可视化方面优于吲哚菁绿成像 (ICG)，包括按需重复使用、无需染料以及注射和显示之间没有延迟。 在此，作者报告了一种结合专有 LSCI 处理和 ICG 的新型设备的首次人体临床比较，用于在 RAS 和腹腔镜手术期间进行实时灌注评估。

方法
ActivSight 成像模块集成在标准腹腔镜相机和内窥镜之间，能够在腹腔镜手术中通过 LSCI 和 ICG 检测组织血流。 从 2020 年 11 月到 2021 年 7 月，作者研究了它在选择性机器人辅助和腹腔镜胆囊切除术、结直肠手术和减肥手术中的使用 (NCT# 04633512)。 对于 RAS，使用带有 ActivSight 成像模块的辅助腹腔镜进行 LSCI/ICG 可视化。 作者使用最终用户/外科医生人为因素测试（李克特量表 1-5）确定了 LSCI 在 RAS 与腹腔镜手术中的安全性、可用性和实用性，并将结果与双尾 t 检验进行了比较。

结果
67 名患者被纳入研究——40 名 (60%) RAS 与 27 名 (40%) 腹腔镜手术。 两组患者的人口统计数据相似。 腹腔镜组和 RAS 组均未观察到对患者和外科医生的不良事件。 使用辅助腹腔镜系统进行 LSCI/ICG 可视化对 RAS 的可用性影响最小，外科医生对设备可用性的评级（设置 4.2/5 和外形因素 3.8/5）证明了这一点。 LSCI 检测灌注的能力（RAS 为 97.5%，腹腔镜为 100%）在 RAS 和腹腔镜病例中具有可比性。

结论
LSCI 在检测 RAS 和腹腔镜手术中的实时组织灌注/血流方面展示了可比的实用性和可用性。

激光散斑对比成像 (LSCI) 在机器人辅助手术 (RAS) 中显示实时组织灌注/血流的效用...

图 1
ActivSight示意图

激光散斑对比成像 (LSCI) 在机器人辅助手术 (RAS) 中显示实时组织灌注/血流的效用...

图 2
结肠灌注

激光散斑对比成像 (LSCI) 在机器人辅助手术 (RAS) 中显示实时组织灌注/血流的效用...

图 3
胃切除灌注

激光散斑对比成像 (LSCI) 在机器人辅助手术 (RAS) 中显示实时组织灌注/血流的效用...

图 4
腹腔镜胆道ICG

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