Surgical Displays Reveal Minimally Invasive Model

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 - Pediatric Operating Room
Four new minimally invasive, fully integrated pediatric operating rooms at Florida Hospital for Children combine boom-mounted surgical displays with less bright “green” lighting technology to help increase clarity and ease eye strain during surgical procedures.
Source: Florida Hospital for Children

In the last few years, surgical displays have transformed surgical procedures by enhancing visualization and precision and enabling minimally invasive procedures, which, in turn, can cut recovery time, length of stay, costs and infection rates.

Wall- or boom-mounted monitors and workstations on wheels (WOWs) use high-resolution and higher-definition (HD) displays to show multiple images. Monitor sizes vary from 19 inches to 24 inches and extend to more than 50 inches. Images are displayed in high definition 1080p60 (progressive scan, 60 frames per second), and 1920x1080 pixel resolution improves on the naked eye by 10-fold. Multiple views allow surgeons to adjust images to the procedure and provide panoramic, real-time views of surgical instruments, anatomy and patient data as well as pre-operative images.

Now and then

The advent of an array of display options and ability to integrate multiple displays in surgical suites has improved surgical processes in multiple ways. For starters, improved visualization can translate into shorter, more precise procedures.

“We’ve come a long way since the days of one or two surgical displays in each OR.  Now we have five or six in each OR and most are at least 50 inches wide. Potential tissues that may not be as healthy and were the extensions of tumors might be easier to define because display clarity is so much better,” explains Michael A. Keating, MD, pediatric urologist at the Walt Disney Pavilion at the Florida Hospital for Children in Orlando. With real-time views of the operation, surgeons also can identify and address potential problems, such as bleeding, as they occur.

Indeed surgical displays are integral to less invasive surgical procedures, which are based on small incisions. “In the past, a varicose vein of the testicle [varicocele] would be corrected through an inguinal incision and an operating microscope was often employed. Now we do this procedure laparoscopically with the same kind of magnification. It’s a much quicker operation with a less painful recovery,” offers Keating.

Improved visualization not only helps surgeons better identify problems and facilitates less invasive procedures but also assists with the accurate localization of sensitive structures to be avoided during surgery. “The precision and magnification of the displays can [help surgeons] preserve nerves and vessels that they may not have seen prior to the technology,” explains Lisa Roux-Coggins, vice president of surgical services at Catholic Medical Center in Manchester, N.H. Roux-Coggins adds decreased anesthesia to the list of patient-friendly, cost-cutting benefits associated with the less invasive laparoscopic model.

The gains accrue beyond the surgical suite. “We see shorter recovery times for the patient because wounds are smaller and infections rates are lower,” adds Kevin King, administrative director of diagnostic imaging at Catholic Medical Center. Further downstream these changes may translate into shorter lengths of stay.

A central role

High-definition displays are central to the 21st century surgical suite and often are placed next to the patient or surgeon. Thomas T. Le, MD, director, assistant professor of otorhinolaryngology-head and neck surgery at the University of Maryland School of Medicine, performs endoscopic procedures with the display right in front of his face, allowing him to visualize inside a tight wound. Displays also are used to show 3D CT models for facial reconstruction procedures. With a global image of the skull, the surgeon can avoid making a large incision. In addition, Le says that the displays save time because surgeons can view the images in 3D rather than having to visualize each individual slice of the model.

What’s next?

“As the technology continues to improve the size of the minimally invasive instruments will get smaller, and the utility and the features that are available with the monitors and the scopes will improve,” Keating predicts. “We will probably have 3D scopes and … 3D monitors on the walls soon.”