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. Patents on software/stabilization algorithms as well as optical aspects of PerfusiX-Imaging devices are the results of our research and development efforts.


PerfusiX-Imaging visualizes the colon tissue perfusion instantaneously, continuously, dye free, hassle free and without extra instruments attached to the scope. It aims to provide the confidence for the surgeon and patient that the placement of the anastomosis will be in the optimal location to help prevent anastomotic leakage. We are conducting research in other clinical applications such as esophageal resections. We are in process for preparing for the product certification. More to come.

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

PerfusiX-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 PerfusiX-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, PerfusiX-Imaging does not require any dye nor other injectable.
  • Hardware agnostic: PerfusiX-Imaging
  • No extra weight added to the laparoscope: PerfusiX-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 PerfusiX-Imaging and connected research aspects.

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.