Dennis L. Fowler. M D., Nancy J. Hogle, B.S.N., Department of Surgery, Allegheny General Hospital, Pittsburgh, PA.

The use of ultraviolet (UV) light and fluorescein dye to evaluate intestine for ischemia is an established technique. However, transmission of UV light and the resultant fluorescence back through a laparoscope to evaluate intestinal ischemia has not been reported.

Using general anesthesia, five 25 kg pigs were evaluated laparoscopically. A 10-15 cm segment of small intestine was devascularized until the intestine became visibly ischemic. Two filters (Karl Storz Endoscopy, Culver City, CA) were placed, one between the light source and the light cable to filter all but UV light, and one between the laparoscope and the video camera to filter all but the frequency of the fluorescence. Fluorescein was given IV while observing laparoscopically with the UV light. Videotape and digital still pictures documented the laparoscopic findings. Comparative documentation via laparotomy was also completed in each animal.

Viable intestine and all other viable tissues were visualized laparoscopically as fluorescent in all cases, while the ischemic intestine was seen as a silhouette against the fluorescing tissue. Videotape and digital still images adequately documented the findings both laparoscopically and under direct visualization in each case.

With the simple addition of two filters to standard videolaparoscopic equipment, ischemic intestine can be defined laparoscopically in the animal model. This has potential clinical application both for diagnosis of ischemic intestine and also for second look procedures.



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