Technologies are provided for an opto-mechancial device is provided for enabling surgeons to rapidly simulate proposed intestinal/colorectal anastomosis cut lines and assess their impact upon tissue perfusion prior to their implementation. The pre-selection process enables a surgeon to decide upon the locations of the anastomotic cut lines that are most likely to reduce ischemia, while preserving most of the intestinal tissue length. The opto-mechanical device may simulate a cut line by applying pressure to intestinal tissue and detecting a light pattern transmitted through the intestinal tissue before and after the applied pressure. A perfusion map may be generated to estimate perfusion quality around the circumference of the intestinal tissue at the site of a simulated cut line, and the perfusion map may be displayed as a two-dimensional graphic image of the proposed anastomosis site. Once the site of the best cut line is selected, the surgeon may activate a cutting blade to implement the cut.