Feasibility of laser speckle contrast imaging using the bowel perfusion assessment tool Lapvas-Imaging

For colorectal cancer, the third most commonly occurring malignancy worldwide, surgery remains the primary therapeutic modality. However, anastomotic leakage (AL) is a major problem in gastrointestinal surgery. The general consensus is that an important factor regarding AL is the state of microcirculation at the site of the anastomosis. It is expected that a better state of microcirculation contributes to a fast healing process which in term leads to a lower incidence of AL. Lapvas-Imaging is contactless, dye-free real time perfusion imaging tool that gives insight in the state of perfusion of live tissue during laparoscopic surgery. The overall objective of this study is to determine whether the use of additional Lapvas-imaging derived visual feedback might influence the choice of surgeons for the optimal location of the anastomosis.

the current intraoperative selection of an optimal site for the anastomosis is based on subjective clinical indicators of intestinal viability. As indicated by others there is a need for a gold standard in determining the state of microcirculation of the intestines. This method should be suitable for laparoscopic use, robust and preferably non-invasive. Using Lapvas-Imaging, real-time feedback can be obtained and used for clinical decision-making during surgery, which might be beneficial to the patient. In this prospective observational feasibility study, we aim to determine whether surgeons would choose a different location for the original anastomosis, based on additional Lapvas-imaging derived visual feedback

Images will be acquired during surgery using Lapvas-Imaging before the surgeon dissects the (1) proximal and (2) distal end of the anastomosis. The surgeons will subsequently be questioned using these images.