Document Detail


Renal oxygenation during robotic-assisted laparoscopic partial nephrectomy; characterization using laparoscopic digital light processing (DLP®) hyperspectral imaging.
MedLine Citation:
PMID:  22973969     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Introduction Digital light processing-based hyperspectral imaging (DLP®-HSI) was adapted for use during laparoscopic surgery by coupling the spectral illumination source with a conventional laparoscopic light guide and incorporating a customized digital charge-coupled device camera for image acquisition. The system was used to characterize renal oxygenation during robotic-assisted laparoscopic partial nephrectomy (RALPN) in humans. Methods After Institutional Review Board approval, laparoscopic DLP®-HSI was performed in consecutive patients undergoing RALPN at our institution. Time trends in relative tissue oxygen saturation (%HbO2) were descriptively analyzed. Associations between %HbO2 and patient age, comorbidities and estimated glomerular filtration rate (eGFR) were investigated using Kendall's tau test. Results Laparoscopic DLP®-HSI was performed in 18 patients between May 2011 and February 2012. Median (interquartile range; IQR) age was 55.9 (49-67.5) years. 10/18 (56%) were male and 12/18 (66.7%) had a history of hypertension, diabetes and/or tobacco use. Median (IQR) %HbO2 before, during and after ischemia was 60.8 (57.9-68.2)%, 53.6 (46.8-55.1)% and 61.5 (54.9-67.6)% respectively. Baseline %HbO2 was inversely associated with preoperative eGFR (τ = -0.38; p= 0.036), and eGFR at most recent follow-up (τ = -0.38; p= 0.036). Baseline or ischemic %HbO2 did not correlate with hypertension, diabetes and/or tobacco history. Younger patients (< 56 years) had a lower median baseline %HbO2 (p=0.07) and a higher median preoperative eGFR (p=0.038), than their older counterparts. Conclusion The laparoscopic hyperspectral imaging system successfully characterized dynamic changes in renal oxygenation during RALPN. Intraoperative laparoscopic hyperspectral imaging outcomes have the potential to predict postoperative individual kidney function.
Authors:
Ephrem Odoy Olweny; Stephen Faddegon; Sara L Best; Neil Jackson; Eleanor F Wehner; Yung K Tan; Karel J Zuzak; Jeffrey A Cadeddu
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-9-13
Journal Detail:
Title:  Journal of endourology / Endourological Society     Volume:  -     ISSN:  1557-900X     ISO Abbreviation:  J. Endourol.     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-9-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8807503     Medline TA:  J Endourol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
UT Southwestern Medical Ctr, Urology, 5323 Harry Hines Blvd, Rm. J8.106, Dallas, Texas, United States, 75390; eolweny@gmail.com.
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