Visualization of Perfusion with the Quest Spectrum™ Platform
Perfusion of organs can be visualized during surgery with help of the Quest Spectrum™ Platform. During an open or laparoscopic procedure, patients are injected with Indo Cyanine Green (ICG) which tightly binds to plasma proteins within the vascular system. This tracer flows through the cardiovascular system to the organ of interest. Then, the Quest Spectrum™ Platform is used to simultaneously record the visible and near-infrared images. The near-infrared images reveal the location of the fluorescent tracer, while the visible images show the location of the organs. These images combined can visualize which organs are perfused.
Colorectal Anastomosis is a complex and time-consuming surgical procedure where a new connection is made between the colon and the rectum. In this procedure it is imperative to assure a closed suture between the two structures to minimize the chance of possible leakage of the intra-colon or intra-rectum fluids. Postoperatively these leakages could induce major complications requiring revision. Besides a closed suture, it is also important that de suture is perfused for optimal recovery. In case the suture is not perfused, the cells might undergo necrosis as a result of ischemia.
The perfusion of the colon during a colorectal anastomosis procedure is shown above. These images were obtained with the Quest Spectrum™ Platform. The left image, shows an image that is similar to what the surgeon sees with the naked eye. This image shows a closed suture without any leakages. However, one cannot estimate the perfusion of the suture based on this image. The right image shows the response of the fluorescent tracer that is used during this procedure. This image shows that the intensity of the fluorescent response is lower at the center of the image compared to the surrounding tissue, indicating a lower perfusion. The image in the middle shows the overlay between the visible image and the fluorescent image. This image allows the surgeon to assess the fluorescent signal regarding the anatomical structures he or she is familiar with. In conclusion, the Quest Spectrum™ Platform can provide additional information to the surgeon to support his decision making.