Real-time infrared thermography for ureter detection during hysterectomy

Background: Recognition of different anatomic structures might be difficult in the presence of diseases such as neoplasm or endometriosis that can subvert the anatomy. This can be a challenge for young surgeons approaching gynecologic surgery. The aim of the present study was to evaluate the effectiveness of infrared thermocamera to identify the anatomic structures in gynecologic surgery. Materials and methods: From February 2010 to May 2011, consecutive patients who required abdominal hysterectomy were considered for eligibility. During a procedure for benign disease, we evaluated the temperature difference between the ureter and infundibulopelvic vessel (experiment A). In patients with gynecologic cancer, the thermal gradient was determined between the iliac vessels and the ureter (experiment B). Results: The data from 21 patients were recorded, 12 for experiment A and 9 for experiment B. We found a statistically significant difference between the ureter and vessels in both experiments (31.675 degrees C +/- 0.673 degrees C for the ureter and 33.332 degrees C +/- 0.828 degrees C for the infundibulopelvic vessel, P < 0.0001; 31.706 degrees C +/- 0.751 degrees C for the ureter, 33.787 degrees C +/- 0.63 degrees C for the iliac vein, and 33.784 degrees C +/- 0.639 degrees C for the iliac artery, P < 0.0001). Conclusions: Infrared imaging allowed us to identify the anatomic structures in laparotomy, providing preliminary data for its application in laparoscopy. Crown Copyright (C) 2012 Published by Elsevier Inc. All rights reserved.