Summary, discussion and future perspectives Not unimportantly, is the role of the end‐user of the optical system. In terms of intraoperative anatomical guidance, the surgeon will most likely handle the new optical tool. Depending on the way spectroscopic data will be presented (preferably image‐wise, so that the surgeon can relate real‐time optical feedback to the conventional surgical view) it has to be determined if and how training of the end‐user is required. It is likely that DRS and/or hyperspectral imaging will eventually serve as an additional intraoperative tool for the surgeon to facilitate automated tissue differentiation (e.g. arterial, ureteral, biliary, nerve) in challenging types of surgery. Applicability is possible in a wide variety of surgical specialties, e.g. general surgery, head and neck surgery, urology, plastic surgery, gynecology and neurosurgery. As with NIRF imaging, the spectroscopic technique will most likely also be incorporated in e.g. robotic systems, enabling real‐time image‐guidance during for example robotic microsurgery41. Ultimately, surgical navigation will move forward to three‐dimensional spectroscopically enhanced endoscopy; not only in telemanipulated (robotic) endoscopic surgery, but also in handheld endoscopy. In conclusion, future implementation of new intraoperative optical methods, such as NIRF or DRS, can provide the surgeon with improved real‐time identification and physiological tissue characterization of essential anatomical structures encountered during a wide variety of surgical procedures. This could significantly contribute to intraoperative anatomy navigation and facilitate critical decision‐making. The NIRF technique is closest to clinical implementation. Endogenous contrast‐based techniques such as DRS can be a strong surgical tool when further development has been completed. Both NIRF and DRS still have their limitations but certainly also have potential to improve surgical care as additive intraoperative tools. This can ultimately result in higher procedural safety and efficiency. Health‐care costs could be reduced by avoiding costly re‐operations (and thereby re‐admission to or longer stay in the hospital) for e.g. repair of a ureteral injury or a common bile duct injury. When certain routine surgical procedures can be performed faster, as a consequence of earlier identification of vital anatomical structures, this can also lead to a cost reduction. 175
proefschrift_Schols_SLV
To see the actual publication please follow the link above