Introduction Innovation

LIMIS Development combines specific medical needs and the execution of research programs with business and marketing concepts towards development of innovative new technologies, products and concepts.


Lapvas-Imaging visualizes the colon tissue perfusion instantaneously, continuously, dye free, hassle free and without extra instruments attached to the scope. It provides the confidence for the surgeon and patient that the placement of the anastomosis will be in the optimal location to help prevent anastomotic leakage.

Perfusion differences become apparent by using Lapvas-Imaging. In this example, the colon had to be shortened (removal of the tumor) and a perfusion difference became clear by using Lapvas-Imaging. These images were made during a study procedure of the SCOUT-I study using standard laparoscopic equipment in conjunction with Lapvas-Imaging.

Anastomotic leakage (AL) is a major complication worldwide with occurrence rates ranging up to 13% and a mortality of around 10%. AL occurs after a colon resection roughly 4 days post-surgery and requires re-operation a prolonged hospitalization. AL is multi-factorial, meaning that it is hard to determine the exact cause, however general consensus is that the state of perfusion at the site of the anastomosis is a major contributor. Currently surgeons determine the state of microcirculation based on subjective measures of viability such as tissue colour, palpable motion or bleeding at the resected edges. Lapvas-Imaging is the development of a laparoscopic tool based on Laser Speckle Contrast Imaging (LSCI) that can visualize the state of microcirculation at any given time during laparoscopic surgery, without the need for injecting a fluorescent dye.

The LIMIS project Lapvas-Imaging is jointly financed by SNN and the European Regional Development Fund and the Ministry of Economic Affairs, Agriculture and Innovation. With this project we invest in your future.

Lapvas-Imaging is highly capable of distinguishing between well and non-perfused tissues. During this experiment on an ex-vivo perfused porcine kidney, we induce a local ischemic area by inflating a catheter that was inserted in the renal artery. The speed at which the large local perfusion difference can be visualized gives an indication of the added clinical value in case of an unwanted local perfusion deficit gives an indication of the added clinical value in case of unwanted local perfusion deficit during a kidney transplant. More information can be found in the recently published article HERE.

Features Lapvas-Imaging:

  • Clear vision of blood flow in tissue.
  • Instantaneous and continuous usage: There is no limit in frequency or duration of use during a procedure.
  • Dye free, Lapvas does not require any dye nor other injectable.
  • Hardware agnostic: Lapvas-Imaging can be connected to any stack and laparoscope.
  • No extra weight added to the laparoscope: Lapvas-Imaging does not add an extra tool on the laparoscope itself.

Reducing Anastomotic Leakage (AL)

Our aim is the reduction of anastomotic leakage

Within our ‘anastomotic leakage’ mission we examine a measuring instrument that is indicative of the quality of tissue of the intestinal wall. This provides an improved parameter for the surgeon’s clinical decision making. This concerns a minimally invasive application. In this project we work together with the UMCG, prof. dr. Gooitzen M. van Dam and medical specialists of the Medical Centre Leeuwarden such as Dr. Christiaan Boerma, Dr. Christiaan Hoff, Dr. Sietze Koopal and Prof. Dr. Jean Pierre Pierie and Computer Vision specialist Dr. Klaas Dijkstra of NHL/Stenden. Furthermore, LIMIS-Development PhD researcher Wido Heeman (MSc) is conducting several clinical and non-clinical studies in the field of applications of Lapvas-Imaging and connected research aspects.

Virtual OR (former project)

The virtual operating room (OR) is a training tool for OR assistants. OR assistants learn how to handle complicated OR equipment and simulate realistic situations. This contributes to a safe and efficient OR environment.

The virtual OR is a fully equipped virtual operating room in which you can walk to the equipment and operate it with your mouse or controller. The virtual instruments have all the possibilities that the real equipment also has. In the virtual room you can simulate realistic problems and learn how you can resolve them. It is a good way to playfully train in the use of operating techniques.

ICT plays an important role in improving the efficiency and effectiveness of training programmes. This provides many benefits. The surgeon does not practice on a patient and can therefore cause no damage. The operation can be repeated as often as is necessary. The program keeps score and shows who has already performed a specific training. In addition, the virtual room also provides information about the layout of the operating room and the ergonomics. The virtual operating room is developed in cooperation with Grendel Games and Olympus Europe. A number of scenarios have been realized.

Lap Wii Trainer (former project)

The Nintendo Wii U Laparoscopy Trainer is a training game for laparoscopic skills on a standard Nintendo Wii U as replacement for an expensive simulator. This innovation is developed by Cutting Edge, a collaboration between UMCG, Grendel Games and LIMIS. An inexpensive, innovative and sustainable solution has been developed for training the skills necessary for exploratory surgery. Research has shown that simulators are often boring, ineffective and expensive. Due to their highly technical nature simulators are susceptible to defects and generate high maintenance costs. This has led to the collaboration and a challenging, accessible and validated solution has been developed together with game developers. The development of the hardware has been handled in partnership with Pezy Product Innovation. The product ‘Underground’ is also available in the Nintendo web-shop.