Non-invasive monitoring of tissue oxygenation during laparoscopic donor nephrectomy

We have developed a method for the real time, in vivo, whole organ assessment of tissue oxygenation during laparoscopic nephrectomy to convey meaningful biological data to the surgeon during laparoscopic surgery. We apply the 3-CCD (charge coupled device) camera to monitor qualitatively renal parenchymal oxygenation with potential real-time video capability.We have validated this methodology in a porcine model across a range of hypoxic conditions, and have then applied the method during clinical laparoscopic donor nephrectomies during clinically relevant pneumoperitoneum. 3-CCD image enhancement produces mean region of interest (ROI) intensity values that can be directly correlated with blood oxygen saturation measurements (R2 > 0.96). The calculated mean ROI intensity values obtained at the beginning of the laparoscopic nephrectomy do not differ significantly from mean ROI intensity values calculated immediately before kidney removal (p > 0.05).Here, using the 3-CCD camera, we qualitatively monitor tissue oxygenation. This means of assessing intraoperative tissue oxygenation may be a useful method to avoid unintended ischemic injury during laparoscopic surgery. Preliminary results indicate that no significant changes in renal oxygenation occur as a result of pneumoperitoneum.In the past 10 years the use of living donor kidneys have markedly increased and in 2003 surpassed deceased donors as the predominant source of donor organs [1]. Laparoscopic donor nephrectomy has become a major driving force in increasing the acceptance of living donation. Laparoscopic donor nephrectomy (LDN) is thought to have several potential advantages over open donor nephrectomy (ODN) [1,2]. Namely, laparoscopic procedures require a shorter hospital stay, decreased amounts of analgesia, allow for a faster return to work and provide improved cosmesis. However, disadvantages of laparoscopic surgery include slightly longer warm ischemic times, and increased incidences of delayed graft functi