Laparoscopic Infrared Imaging Video

click here to start

You must have RealPlayer G2 to view this video.
If you do not have it, click the icon for a FREE download.

Produced in coordination with the following:

Salvatore Micali, MD               Timothy D. Averch, MD
William W. Roberts, MD          Leonard Bonnell
Peter Schulam, MD                 Louis R. Kavoussi, MD

Special thanks to: Thomas Brukilacchio and Dennis Leiner, Vipera Systems, Inc.

Brady Urological Institute, Johns Hopkins Medical Center, Baltimore, MD

Laparoscopy is the most well known example of minimally invasive surgery and has demonstrated significantly less post operative morbidity when compared to traditional open surgery. This has resulted in the increasing demand for laparoscopy alternatives. However, these procedures are associated with steep learning curves resulting from limitations imposed by the unique laparoscopic environment, specifically in the

	lack of tactile feedback
	2D imaging
	requirement for hand dissociation

We explored the use of IR imaging as a means of obtaining additional anatomic and physiologic information during laparoscopic procedures in an attempt to lessen the challenge of laparoscopy.

Our system was specifically designed to detect the energy emitted from the body in the mid IR range from 3-6 microns. IR uses a black and white scale that distinguishes gradations from as small as 1/10 of one degree. Warm areas appear white while cool areas appear black.

The video showed in vivo testing used to identify blood vessels and assess perfusion, enhanced by room temperature saline wash. Vessel position can be confirmed through real time IR imaging. It is easy to see that working with IR is not disorienting.

Potential clinical applications of IR imaging include:

	evaluation of blood supply to bowel in patients with mesenteric ischemia
	localization of ureteral stone during ureterolithotomy
	assessment of testicular blood flow during laparoscopic orchidopexy
	localization of ureter during the laparoscopic retroperitoneal fibrosis procedure
	localization and identification of vessels
	identification of cancerous and precancerous lesions based on differential blood flow

Initial studies with this system appear very promising. The next step is to demonstrate the clinical applicability of the instrument. Several design changes are suggested to be implemented:

	reduce diameter size from 15mm to 10mm
	reduce the IR/visible camera to be the size of current visible cameras
	design a simple surgeon control switch that would allow rapid alternation between IR and visible imaging

IR has potential to enhance laparoscopic knowledge of anatomical detail and may develop to be a very powerful agent to laparoscopy.

[ Home ] [ Up ] [ Video ] [ Distal View ] [ Video Set-up ] [ Cameras ]

Send mail to webmaster with questions or comments about this web site.