Novadaq® Technologies Inc, developer of real-time imaging and image guidance systems
for use in the operating room, announces that plastic surgeons at Duke University Hospital
in Durham, North Carolina, are routinely using the SPY(R) Imaging System in plastic
reconstructive surgical procedures.

L. Scott Levin, MD, and Michael R. Zenn, MD, have been using the system since the end of 2007. They have completed 50 SPY procedures during a variety of muscle, bone, and free tissue or "perforator flap" plastic reconstructive surgeries for the treatment of
traumatic injuries, congenital deformities, and various cancers.

Use of a patient’s own tissue to create a new body part is rapidly gaining popularity.
In these surgeries, tiny vessels called perforators provide the blood supply to a
tissue "flap" known as a "perforator" flap. These flaps can be transferred from
numerous donor sites to almost any other part of the body. During the procedure, these
microscopic sized vessels are co-joined to recipient vessels to supply blood to the
reconstructed tissue. Locating the most appropriate perforator vessel is critical to
achieving successful outcomes, but is often a lengthy process for the surgeon and OR

In the past, surgeons have used doppler ultra-sound and most recently
computer tomography (CT) scanning to assist the identification process.
However, since perforator vessels are so small, doppler ultra-sound has often
been ineffective and CT cannot be performed in the operating room. The SPY
System is the only fluorescent imaging system that allows plastic surgeons to
visually assess blood flow in co-joined vessels, micro-vasculature, and related
tissue perfusion in real-time.

Levin and Zenn were the first to use SPY to intra-operatively locate
and assess the quality of perforator vessels. They are in the process of completing
an independent clinical study using SPY to identify perforator vessels prior to flap
harvest and are comparing SPY intra-operative imaging to pre-operative CT. They
intend to submit the results of their study to a peer reviewed scientific journal
in the near future.

"Our initial experience indicates that SPY has great potential to improve
the technical performance and results of perforator flap reconstructive
surgery," says Levin. "If, as we believe today, the results of our study find SPY to
be equally as effective in identifying perforator vessels in the OR as pre-op CT,
there is no doubt that the clinical benefits and cost savings will lead toward
establishing SPY as a standard of care in our specialty."

[Novadaq Technologies, May 8, 2008]