Research Papers: Sensing

Feasibility of quantitative diffuse reflectance spectroscopy for targeted measurement of renal ischemia during laparoscopic partial nephrectomy

[+] Author Affiliations
Utsav O. Goel

Tulane University School of Medicine, Department of Urology, New Orleans, Louisiana 70112, United States

Michael M. Maddox

Tulane University School of Medicine, Department of Urology, New Orleans, Louisiana 70112, United States

Katherine N. Elfer

Tulane University, Department of Biomedical Engineering, New Orleans, Louisiana 70118, United States

Philip J. Dorsey

Tulane University School of Medicine, Department of Urology, New Orleans, Louisiana 70112, United States

Mei Wang

Tulane University, Department of Biomedical Engineering, New Orleans, Louisiana 70118, United States

Ian Ross McCaslin

Tulane University School of Medicine, Department of Urology, New Orleans, Louisiana 70112, United States

J. Quincy Brown

Tulane University, Department of Biomedical Engineering, New Orleans, Louisiana 70118, United States

Benjamin R. Lee

Tulane University School of Medicine, Department of Urology, New Orleans, Louisiana 70112, United States

J. Biomed. Opt. 19(10), 107001 (Oct 08, 2014). doi:10.1117/1.JBO.19.10.107001
History: Received June 13, 2014; Revised August 25, 2014; Accepted September 16, 2014
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Abstract.  Reduction of warm ischemia time during partial nephrectomy (PN) is critical to minimizing ischemic damage and improving postoperative kidney function, while maintaining tumor resection efficacy. Recently, methods for localizing the effects of warm ischemia to the region of the tumor via selective clamping of higher-order segmental artery branches have been shown to have superior outcomes compared with clamping the main renal artery. However, artery identification can prolong operative time and increase the blood loss and reduce the positive effects of selective ischemia. Quantitative diffuse reflectance spectroscopy (DRS) can provide a convenient, real-time means to aid in artery identification during laparoscopic PN. The feasibility of quantitative DRS for real-time longitudinal measurement of tissue perfusion and vascular oxygenation in laparoscopic nephrectomy was investigated in vivo in six Yorkshire swine kidneys (n=three animals). DRS allowed for rapid identification of ischemic areas after selective vessel occlusion. In addition, the rates of ischemia induction and recovery were compared for main renal artery versus tertiary segmental artery occlusion, and it was found that the tertiary segmental artery occlusion trends toward faster recovery after ischemia, which suggests a potential benefit of selective ischemia. Quantitative DRS could provide a convenient and fast tool for artery identification and evaluation of the depth, spatial extent, and duration of selective tissue ischemia in laparoscopic PN.

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© 2014 Society of Photo-Optical Instrumentation Engineers

Citation

Utsav O. Goel ; Michael M. Maddox ; Katherine N. Elfer ; Philip J. Dorsey ; Mei Wang, et al.
"Feasibility of quantitative diffuse reflectance spectroscopy for targeted measurement of renal ischemia during laparoscopic partial nephrectomy", J. Biomed. Opt. 19(10), 107001 (Oct 08, 2014). ; http://dx.doi.org/10.1117/1.JBO.19.10.107001


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