ORIGINAL RESEARCH article
Front. Med. Technol.
Sec. Animal Models in Medical Translation
Volume 7 - 2025 | doi: 10.3389/fmedt.2025.1549245
Hyperspectral Abdominal Laparoscopy with Real-Time Quantitative Tissue Oxygenation Imaging: A Live Porcine Study
Provisionally accepted
Oscar MacCormac1,2*
Conor C Horgan1,3
Dale Waterhouse1,3Philip Noonan1,3Mirek Janatka1,3Richard Miles1,3Jaco Jacobs1,3Cameron Dockerill1,3Théo Trotouin1,3Alexis Schizas4
Barbara Seeliger5,6,7,8Sebastien Ourselin1,3Michael Ebner1,3
Tom Vercauteren1,3
Jonathan Shapey1,2,3- 1School of Biomedical Engineering & Imaging Sciences, Faculty of Life Sciences & Medicine, King's College London, London, United Kingdom
- 2Department of Neurosurgery, King's College Hospital NHS Foundation Trust, London, England, United Kingdom
- 3Hypervision Surgical Ltd, London, United Kingdom
- 4Guy's and St Thomas' NHS Foundation Trust, London, London, United Kingdom
- 5Institut de Chirurgie Guidée par l'Image (IHU), Strasbourg, Alsace, France
- 6Department of General, Digestive, and Endocrine Surgery, University of Strasbourg, Strasbourg, France
- 7ICube, UMR 7357 CNRS, IHU Strasbourg, Strasbourg, France
- 8Research Institute against Digestive Cancer, Strasbourg, Alsace, France
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Background: Ischaemia is a critical complication, and can result in poor surgical outcomes.While intra-operative overt ischaemia can be perceived with the naked eye, timely recognition of borderline perfusion can prevent post-operative ischaemic complications, which is particularly relevant for colorectal anastomoses. Consequently, there is a clinical need for new technologies to intra-operatively assess tissue oxygenation (indicative of end organ perfusion), with minimal disruption to the surgical workflow. Here we present a hyperspectral imaging (HSI) system for laparoscopic surgery. This system provides live, easy to interpret, tissue oxygenation (StO 2 ) maps with associated quantitative values.Methods: White light view and tissue oxygenation maps were reconstructed from a protoype laparoscopic Hyperspectral Surgical System (HSS). First, in a live porcine model (55kg female), the mesentery of a small bowel loop was temporarily occluded with a laparoscopic grasper, then released whilst being imaged with HSI. The quantitative StO 2 values obtained from the HSS were compared with those of a non-invasive tissue oximetry probe (Moor VMS-Oxy, Moor Instruments Ltd, United Kingdom). Secondly, mimicking a laparoscopic colon resection and anastomosis, the colorectal junction was mobilised laparoscopically, exteriorised, transected, anastomosed and repositioned in the abdominal cavity. In order to compare healthy and ischaemic colon, the distal part was intentionally devascularised. Tissue oxygenation maps were compared with indocyanine green fluorescence angiography (ICG-FA) of the anastomotic region.The HSS was used as the primary scope to complete a laparoscopic colorectal anastomosis, providing a simultaneous white light view and hyperspectral information.Quantitative results from small bowel imaging were shown to correlate with measurements from the superficial tissue oximetry probe. Real-time tissue oxygenation maps were shown to visually correlate with ICG-FA.i MacCormac et al.The HSS can guide laparoscopic surgical procedures whilst providing visual and quantitative tissue oxygenation information in a live animal model. This paves the way for further studies to assess clinical applications.
Keywords: hyperspectral imaging, Laparoscopy, minimally invasive surgery, tissue oxygenation, StO 2, Anastomosis
Received: 20 Dec 2024; Accepted: 20 May 2025.
Copyright: © 2025 MacCormac, Horgan, Waterhouse, Noonan, Janatka, Miles, Jacobs, Dockerill, Trotouin, Schizas, Seeliger, Ourselin, Ebner, Vercauteren and Shapey. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Oscar MacCormac, School of Biomedical Engineering & Imaging Sciences, Faculty of Life Sciences & Medicine, King's College London, London, United Kingdom
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