INTRODUCTION: Fibered optical coherence tomography (OCT) in conjunction with natural orifice transluminal endoscopic surgery (NOTES) could provide a facility for rapid, in situ pathological diagnosis of intraperitoneal tissues in a truly minimally invasive fashion. MATERIALS AND METHODS: A large porcine model was established to test this hypothesis. A standard double channel gastroscope (Olympus) was used to achieve a transgastric access to the peritoneum and initiate the pneumoperitoneum. Magnetic retraction was used to display the sigmoid colon along with its mesentery. A commercially available fibered OCT probe (NIRIS system, Imalux) was inserted via a working channel of the gastroscope and used to assess intraperitoneal tissues. Separately, OCT images of human tissue specimens ex vivo were contrasted with representative standard histopathological slides. RESULTS: Intraperitoneal OCT provided clear real-time images of both the serosal and muscularis propria mural layers as well as the submucosal-muscularis interface. Examination of mesenteric lymph nodes (including sentinel nodes) allowed visualization of their subcapsular sinus. Comparison of representative cross-sections however failed to evince sufficient resolution for confident diagnosis. CONCLUSION: This approach is technically feasible and, if the technology is advanced and proven accurate in human patients, could potentially be used to individualize operative extent prior to definitive resection.
INTRODUCTION: Fibered optical coherence tomography (OCT) in conjunction with natural orifice transluminal endoscopic surgery (NOTES) could provide a facility for rapid, in situ pathological diagnosis of intraperitoneal tissues in a truly minimally invasive fashion. MATERIALS AND METHODS: A large porcine model was established to test this hypothesis. A standard double channel gastroscope (Olympus) was used to achieve a transgastric access to the peritoneum and initiate the pneumoperitoneum. Magnetic retraction was used to display the sigmoid colon along with its mesentery. A commercially available fibered OCT probe (NIRIS system, Imalux) was inserted via a working channel of the gastroscope and used to assess intraperitoneal tissues. Separately, OCT images of human tissue specimens ex vivo were contrasted with representative standard histopathological slides. RESULTS: Intraperitoneal OCT provided clear real-time images of both the serosal and muscularis propria mural layers as well as the submucosal-muscularis interface. Examination of mesenteric lymph nodes (including sentinel nodes) allowed visualization of their subcapsular sinus. Comparison of representative cross-sections however failed to evince sufficient resolution for confident diagnosis. CONCLUSION: This approach is technically feasible and, if the technology is advanced and proven accurate in humanpatients, could potentially be used to individualize operative extent prior to definitive resection.
Authors: Field F Willingham; Denise W Gee; Patricia Sylla; Avinash Kambadakone; Anand H Singh; Dushyant Sahani; Mari Mino-Kenudson; David W Rattner; William R Brugge Journal: Gastrointest Endosc Date: 2009-06-27 Impact factor: 9.427
Authors: Soroush Rais-Bahrami; Adam W Levinson; Nathaniel M Fried; Gwen A Lagoda; Alexandra Hristov; Ying Chuang; Arthur L Burnett; Li-Ming Su Journal: Urology Date: 2008-02-20 Impact factor: 2.649
Authors: Richard C Newton; David P Noonan; Valentina Vitiello; James Clark; Christopher J Payne; Jianzhong Shang; Mikael Sodergren; Ara Darzi; Guang-Zhong Yang Journal: Surg Endosc Date: 2012-04-26 Impact factor: 4.584
Authors: Ronan A Cahill; Mark Anderson; Lai Mun Wang; Ian Lindsey; Chris Cunningham; Neil J Mortensen Journal: Surg Endosc Date: 2011-08-19 Impact factor: 4.584
Authors: Boudewijn E Schaafsma; Floris P R Verbeek; Joost R van der Vorst; Merlijn Hutteman; Peter J K Kuppen; John V Frangioni; Cornelis J H van de Velde; Alexander L Vahrmeijer Journal: J Surg Res Date: 2013-01-25 Impact factor: 2.192