Image-guided thoracoscopic segmentectomy via single-shot statistical gating of blood-scattered laser speckle

Abstract

Accurate identification of target lung segments during thoracoscopic surgery is critical for successful lung cancer resections but remains challenging with conventional thoracoscopic imaging techniques. We present a real-time statistical gating method that leverages the single-shot laser speckle pattern generated by an 840 nm laser to isolate the blood-scattered speckle component in lung tissue. This enables background-free measurement of hemoglobin’s absorption, thereby markedly improving the sensitivity of tissue oxygen saturation detection. Clinical trials demonstrated a 2.05-fold increase in boundary slope steepness and a 220% improvement in the mean absolute derivative metric, enabling precise differentiation of the segment’s boundary during lung segmentectomy.