The analysis of data from relevant domestic and foreign literature on the intraoperative determination of intestinal viability using modern diagnostic methods in various diseases of the abdominal cavity accompanied by impaired blood supply to the intestinal wall is presented in this work. The analysis is based on the concept of mesenteric ischemia and the methods of its intraoperative assessment, which are described in the literature. Methods: An analysis of the literature on intraoperative assessment of intestinal ischemia using online search engines, libraries, and various databases was conducted. Mesenteric blood supply disorders, often found in surgical practice, are the result of several causes (mesenteric thrombosis, acute adhesive intestinal obstruction, strangulated hernia, etc.), and they are a high-risk factor for death.Special attention is paid to the occlusive pathogenic mechanism of mesenteric ischemia, which leads to rapid development of irreversible morphological changes in tissues and pronounced disruption of the body's homeostatic system. The currently available intraoperative method for visual assessment of intestinal viability does not provide unambiguous results in determining the severity of ischemic changes in the intestinal wall. The algorithm for assessing intestinal viability includes evaluating the color of the intestinal wall, presence of peristaltic activity, pulsation, and blood flow in mesenteric vessels. These signs are assessed dynamically after administering a local anesthetic solution to the intestinal mesentery and warming the intestine with sodium chloride-soaked napkins. However, surgeons currently require a more comprehensive intraoperative evaluation of organ perfusion during surgery.Clinical recommendations for an objective assessment of intestinal blood supply: If technically feasible, it is recommended to utilize intraoperative ultrasound, laser Doppler flowmetry, and regional transillumination angiotensometry of the intravenous vessels of the small intestine to assess the blood supply. These methods are highly sensitive to changes in blood microcirculation. However, there is still ambiguity in the literature regarding the effectiveness of these methods for assessing regional hemomicrocirculatory disorders and intestinal viability. Therefore, further research is needed to study and evaluate the use and effectiveness of these techniques.
