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

Utsav O. Goel, Michael M. Maddox, Katherine N. Elfer, Philip J. Dorsey, Mei Wang, Ian Ross McCaslin, J. Quincy Brown, Benjamin R. Lee

Research output: Contribution to journalArticle

6 Scopus citations

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 selec tive 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.

Original languageEnglish (US)
Article number107001
JournalJournal of biomedical optics
Volume19
Issue number10
DOIs
StatePublished - Oct 1 2014
Externally publishedYes

Keywords

  • Diffuse reflectance
  • Ischemia
  • Kidney
  • Laparoscopy
  • Spectroscopy
  • Surgery

ASJC Scopus subject areas

  • Electronic, Optical and Magnetic Materials
  • Biomaterials
  • Atomic and Molecular Physics, and Optics
  • Biomedical Engineering

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