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LAPVAS-Imaging

IMAGE THE FLOW OF BLOOD DURING SURGERY

Project LAPVAS-Imaging is a collaboration between LIMIS Development BV, Medisch Centrum Leeuwarden (MCL) and ZiuZ Visual Intelligence. The goal of the project is to create a system that can image the blood flow during surgery in order to help surgeons.

Colon cancer is one of the most frequent forms of cancer for which different treatments exist. Often it is necessary to remove part of the colon and reattach the remaining parts by means of laparoscopic surgery. During this operation there is a risk of anastomotic leakage that can have serious consequences for the patient. Anastomotic leakage is a major complication worldwide with occurrence rates ranging up to 13% and a mortality rate of around 10%. Anastomotic leakage occurs after a colon resection roughly 4 days post-surgery and often requires re-operation and prolonged hospitalization. Anastomotic leakage is multi-factorial, meaning that it is hard to determine the exact cause, however, the general consensus is that the state of perfusion at the site of the anastomosis is a major contributor. Currently surgeons determine the state of microcirculation based on subjective measures of viability such as tissue colour and palpable motion or bleeding at the resected edges.

The goal of Project LAPVAS-Imaging is to develop a medical device that presents the surgeons a real-time heatmap of the blood flow during an operation of the colon to select the optimal site for the anastomosis. The blood flow is measured using a technique called Laser Speckle Contrast Imaging (LSCI) where scattered coherent laser light produces a speckle pattern onto a CCD camera due to optical interference. When the tissue does not move, the speckle pattern will not change either. However, when light is scattered by a flow such as in a blood vessel, the speckle pattern will blur out due to the speckles having a fluctuating intensity and the CCD having a finite exposure. The amount of this fluctuation depends on the velocity of the blood flow and can therefore be used as an estimator for the blood flow.

This effect has been demonstrated in literature for pre-clinical and clinical applications like rat brains and many different superficial skin perfusion measurements such as burns and flap surgery. Recently an article was published using LAPVAS-Imaging where we demonstrated the first-in-human laparoscopic application of perfusion measurements using laser speckle contrast imaging. This article can be found here. Currently, we are validating the technique in an isolated perfused splanchnic organ model.  

LAPVAS-Imaging is partially financed by subsidies from the European Union: European Regional Development Fund (via SNN).