Evaluation of the efficacy of wireless sterilizable pulse oximeter in assessment of bowel viability during surgery

Background Intestinal viability is crucial before commencement of any anastomoses or establishment of stomas after resection of the gut for any surgical reason, and depending on the clinical sense and subjective methods alone may result in disastrous results and complications affecting the outcomes of the surgical procedures. There are many techniques available nowadays for assessing bowel viability, but most of them are technically demanding and not usually available in the operating theater, besides the cost of many of them, which may represent another added burden. For all the aforementioned reasons, the wireless pulse oximeter (PO) has emerged as a possible new method which can aid in assessment of bowel viability during surgeries with the advantages of availability, low cost, and simple rapid way of gut viability assessment. Purpose The aim of this study was to evaluate the capability of the wireless PO in discrimination between viable and nonviable intestine intraoperatively before establishment of stomas or intestinal anastomoses. Study design This was a prospective study that included 40 patients who were evaluated intraoperatively by the wireless PO to assess the viability of the proximal and distal ends of the intestine. The intestinal viability in the first 10 patients was also evaluated by the fluorescein dye in addition to the PO. Here, fluorescein was used as a well-established method to validate the new technique of the PO. All the readings were recorded, and patients were followed up for 2 weeks postoperatively to detect any complications related to intestinal ischemia. Results Three cases were complicated: two cases of failed anastomosis with leakage and the third case was ischemic end colostomy stoma. The mean values of PO readings in the noncomplicated group (37 cases) were 95.65 and 96.32% in the proximal and distal segments, respectively, whereas in the complicated group (three cases), mean values were 89 and 87% in the proximal and distal segments, respectively. Conclusion The PO device is safe, portable, and nonsophisticated, which can be used easily by surgeons in assessment of bowel viability during surgery. It takes less time to assess the intestinal viability and is very cost-effective, as one device can be used in multiple patients.