Mucosal and serosal changes after gastric stapling determined by a new "real-time" surface tissue oxygenation probe: a pilot study

Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery
Christopher MyersEric Demaria

Abstract

Although tissue ischemia at surgical anastomoses can cause leakage, stricture, and ulceration, surgeons rely on nonquantitative measures of detecting ischemia (e.g., color changes, pulsation), which are not likely to detect transient or small degrees of ischemia. A new microvascular tissue oximeter probe (T-Stat) provides noninvasive real-time measurement of tissue hemoglobin oxygen saturation (StO(2)). We measured local gastric StO(2) during stapling for transection/pouch creation to assess the reproducibility of measurements, the sensitivity of the mucosa versus serosa to ischemia, and the effect of the proximity to the staple line on the measurement. Anesthetized adult swine (n = 8) underwent laparotomy to transect gastric tissue in vivo with measurements made in 2 locations using 4.8-mm staple height cartridges. Both mucosal and serosal StO(2) decreased significantly when measured adjacent to the staple line compared with baseline (mucosa 3.0% +/- 5.6% versus 42.1% +/- 13.5%, serosa 48.2% +/- 15.1% versus 64.9% +/- 7.6%, P <.05). No significant change was found in the mucosal or serosal StO(2) at baseline compared with 2 cm away (mucosa 42.1% +/- 13.5% versus 32.3% +/- 18.7%, serosa 64.9% +/- 7.6% versus 59.9 +/- 9.4; P >.0...Continue Reading

References

Mar 1, 1997·Anesthesia and Analgesia·M HaisjacklW Hasibeder
Dec 2, 2006·Gastrointestinal Endoscopy·Shai FriedlandRoy Soetikno
Apr 9, 2008·Obesity Surgery·Carlos BallestaMagdiel Gonzales

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Citations

Nov 4, 2015·Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery·Oliver A VarbanUNKNOWN Michigan Bariatric Surgery Collaborative
Jan 25, 2011·The Annals of Thoracic Surgery·Thai H PhamJohn G Hunter
Oct 22, 2016·Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus·Gustav LinderMagnus Sundbom

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