Imaging peritoneal blood vessels through optical coherence tomography angiography for laparoscopic surgery

Laparoscopic surgery presents challenges in identifying blood vessels due to lack of tactile feedback. The image‐guided laparoscopic surgical tool (IGLaST) integrated with optical coherence tomography (OCT) has potential for in vivo blood vessel imaging; however, distinguishing vessels from surrounding tissue remains a challenge. In this study, we propose utilizing an inter‐A‐line intensity differentiation‐based OCT angiography (OCTA) to improve visualization of blood vessels. By evaluating a tissue phantom with varying flow speeds, we optimized the system's blood flow imaging capabilities in terms of minimum detectable flow and contrast‐to‐noise ratio. In vivo experiments on rat and porcine models, successfully visualized previously unidentified blood vessels and concealed blood flows beneath the 1 mm depth peritoneum. Qualitative comparison of various OCTA algorithms indicated that the intensity differentiation‐based algorithm performed best for our application. We believe that implementing IGLaST with OCTA can enhance surgical outcomes and reduce procedure time in laparoscopic surgeries. This study introduces the Image‐Guided Laparoscopic Surgical Tool (IGLaST) combined with Optical Coherence Tomography Angiography (OCTA) for real‐time blood vessel imaging during laparoscopic surgery. Testing on tissue phantoms and in vivo experiments on animal models demonstrated successful identification of hidden blood vessels beneath peritoneum. The integration of IGLaST with OCTA shows promise for improving laparoscopic surgical outcomes.