Dual-display laparoscopic laser speckle contrast imaging for real-time surgical assistance.

Laser speckle contrast imaging (LSCI) utilizes the speckle pattern of a laser to determine the blood flow in tissues. The current approaches for its use in a clinical setting require a camera system with a laser source on a separate optical axis making it unsuitable for minimally invasive surgery (MIS). With blood flow visualization, bowel viability, for example, can be determined. Thus, LSCI can be a valuable tool in gastrointestinal surgery. In this work, we develop the first-of-its-kind dual-display laparoscopic vision system integrating LSCI with a commercially available 10mm rigid laparoscope where the laser has the same optical axis as the laparoscope. Designed for MIS, our system permits standard color RGB, label-free vasculature imaging, and fused display modes. A graphics processing unit accelerated algorithm enables the real-time display of three different modes at the surgical site. We demonstrate the capability of our system for imaging relative flow rates in a microfluidic phantom with channels as small as 200 μm at a working distance of 1-5 cm from the laparoscope tip to the phantom surface. Using our system, we reveal early changes in bowel perfusion, which are invisible to standard color vision using a rat bowel occlusion model. Furthermore, we apply our system for the first time for imaging intestinal vasculature during MIS in a swine.