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Journal of Biomedical Optics

Feasibility of quantitative diffuse reflectance spectroscopy for targeted measurement of renal ischemia during laparoscopic partial nephrectomy
Author(s): Utsav O. Goel; Michael M. Maddox; Katherine N. Elfer; Philip J. Dorsey; Mei Wang; Ian R. McCaslin; J. Quincy Brown; Benjamin R. Lee
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Paper 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.

Paper Details

Date Published: 8 October 2014
PDF: 8 pages
J. Biomed. Opt. 19(10) 107001 doi: 10.1117/1.JBO.19.10.107001
Published in: Journal of Biomedical Optics Volume 19, Issue 10
Show Author Affiliations
Utsav O. Goel, Tulane Univ. School of Medicine (United States)
Michael M. Maddox, Tulane Univ. School of Medicine (United States)
Katherine N. Elfer, Tulane Univ. (United States)
Philip J. Dorsey, Tulane Univ. School of Medicine (United States)
Mei Wang, Tulane Univ. (United States)
Ian R. McCaslin, Tulane Univ. School of Medicine (United States)
J. Quincy Brown, Tulane Univ. (United States)
Benjamin R. Lee, Tulane Univ. School of Medicine (United States)

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