EMERGENCY LAPAROSCOPY - TECHNICAL-SUPPORT FOR THE LAPAROSCOPIC DIAGNOSIS OF INTESTINAL ISCHEMIA

Background: Laparoscopic diagnosis of intestinal ischemia is difficult . Dark-colored bowels are not a reliable indicator for infarction, bec ause there is no correlation between color and oxygenation. The same p icture is produced by intraluminal blood or feces. False diagnoses are described. Methods: We analyzed various techniques for assessing inte stinal oxygenation and perfusion to support laparoscopic diagnosis. In this study laparoscopy was performed on eight pigs. A 10-cm segment o f intestine was fixed to the abdominal wall and rendered ischemic. Mea surements of the ischemic segment and normal intestine were taken usin g laser-Doppler, Doppler ultrasound, spectrophotometer, and pulse oxim eter. Doppler ultrasound and pulse oximetry were unsuitable in our mod el, as was laser-Doppler flowmetry. Results: Only the spectrophotomete r proved a highly sensitive means of assessing bowel oxygenation. Conc lusions: This method provides the desired additional information about intestinal oxygenation, thus helping to interpret the laparoscopic pi cture of dark bowels.