| Esophagectomy is a surgical procedure performed to remove a cancerous portion of the esophagus. The procedure is done by excising the cancerous tissue, pulling the esophagus and stomach together to fill in the gap and suturing the two back together to reform the gastrointestinal (GI) tract. A percentage of patients undergoing the procedure have a potentially fatal complication known as an anastomotic leakage, where the suture tears and complications occur. Currently endoscopy is used, but not all leaks appear distinctly under white light and therefore must be inferred from superficial evidence. There is a need for a tool that can directly measure an indicator of tissue health and indicate a leakage risk prior to its opening. Laser speckle imaging (LSI) is a noninvasive technique which can quantitatively measure blood flow. Because one of the indicators of an anastomotic leak is ischemia and tissue necrosis, LSI has the potential to be a technology which can be applied to preemptively identify the leaks. The work in this thesis describes the design and validation of a fiber-based LSI system in order to determine if LSI is appropriate for this clinical application. Preliminary studies were done to assess the effectiveness of LSI on a fiber-based platform, and then the device was used in a set of proof-of-concept studies, consisting of an occlusion test to measure in-vivo perfusion and the imaging within an esophageal phantom to mimic the clinical environment. The results suggest that LSI is viable on a fiber-based platform and that it is capable of identifying areas of low perfusion within an esophageal environment. |
