Blood flow or perfusion/ischemia is important for surgical decision making especially in the creation of anastomosis. Well-perfused tissue is a prerequisite for a successful anastomosis. Unfortunately, it is not well visible by the naked surgical eye. Consequently, there is a risk for anastomotic leakage and infections in 8-10 percent. The consequences are enormous for hospitals and surgeons but mostly to the patients who can be seriously limited in their quality of life but may even die of the consequences. Hospitals may spend tens of thousands of dollars in IC costs.
Anastomotic leakage is worldwide the most frequent and serious complication after a colon resectomy. Around 10 percent of all resectomies end up in a leakage. For the patient who suffers anastomotic leakage, the mortality rate is around 10 percent. The anastomotic leakage does not happen straight after the surgery, but it usually takes around two days. The cause of anastomotic leakage can be multifactorial, but perfusion is a pre-requisite for avoiding anastomotic leakage. Today surgeons cannot make a reliable perfusion assessment. Most often it is the naked eye unreliably assessing the perfusion trying to distinguish based on tissue color or bleeding of the edges of the colon stumps.
Laser Speckle Contrast Imaging
Laser Speckle Contrast Imaging is the physical property of diffused laser light being reflected. The reflection upon a still object gives a normal monochromatic image. But when there is a moving object on or sub-surface, a little flash is being reflected called a speckle. A recognizable pattern of speckles is created when the operational field is being luminated by diffused laser light and the blood cells sub-surface reflects the speckles.