Kazuhiro Endo, MD, PhD, Satoshi Nishimura, MD, PhD, Asuka Sakata, MD, PhD, Shuji Hishikawa, MD, PhD, Yasunaru Sakuma, MD, PhD, Hisanaga Horie, MD, PhD, Yoshinori Hosoya, MD, PhD, Alan K Lefor, MD, MPH, PhD, FACS, Naohiro Sata, MD, PhD. Jichi Medical University
Introduction: Magnification of the visual field in laparoscopic surgery is an advantage compared to open surgery. Utilizing this advantage in open surgery may improve the safety of operations. However, improvement of the optical system is necessary to further utilize this advantage. We are developing an optical lens system covering the range from macroscopic to microscopic.
Methods: We developed a handheld prototype created by combining the objective lens system of an optical microscope and a telescope lens. A feasibility study using a porcine model was conducted. Macroscopic observation was done at a distance followed by microscopic observation in contact with tissue. First, we observed the operative field macroscopically. We then observed the serosa of the small intestine microscopically, and effects of blood flow occlusion were studied.
Results: (fig.1 and fig.2)
The same visual field as ordinary laparoscopy was achieved during macroscopic observation, while using microscopic observation it was possible to observe the complex peristaltic movements of the intestine. The minute blood vessels of the visceral peritoneum and larger, deeper blood vessels were also observed. When the mesenteric vessels were occluded, changes in peristaltic movement were seen directly. Congestion in blood vessels in the deep layers of the serosa was observed. Improvement in peristalsis and congestion were confirmed by restoring blood flow.
Conclusions: This system enables direct visual observations not possible with conventional optics. This system can be utilized in both laparoscopic and open surgery. The microscopic visual information obtained by this system may help with intra-operative decision making and serve to facilitate safe and precise surgery.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 87651
Program Number: P496
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster