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Helping the Pictures to Tell the Tale

Thu, 01/12/2006 - 10:56am

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Medical records and the documentation of surgical procedures are not what they used to be. Hand-written notes and, occasionally, a few grainy photos used to be enough. Of course, with surgery advancing in leaps and bounds, the surgical documentation process must also keep up with the times.

With so many procedures currently being performed through minimally invasive surgery, a digital image is often the only view a surgeon can get of the actual surgical site. As such, those digital images and video clips of the surgery are incredibly important to the performance and documentation of a procedure. They are needed for consultation, review, and can provide a powerful tool in educating surgeons and students about new and developing procedures.

The technology behind surgical cameras and scopes has been developing along with the surgical techniques, providing surgeons with clearer and higher resolution images and videos, but managing those images and videos has posed a problem. Initially, the technology just wasn’t there to match the surgical equipment. Much of the quality of surgical videos and images was lost to poor VHS recordings.

Now, with images able to be saved on high definition DVDs and other digital media, the quality is better preserved, and modern computer technology has made viewing and sharing the images and videos much easier. Currently, there are a number of companies serving the medical market that are taking the new technology and shaping it to meet the unique needs of surgeons. Thanks to them, what could once only be shown with a collection of finger-smeared still photos can now be viewed in real time and with crystal clear resolution.


The 640 Image Management System from Smith & Nephew can be easily connected to EMR and PACS.
Smith & Nephew Endoscopy is at the forefront of image and video documentation technology with their 640 Image Management System. The 640 is a compact device that allows surgeons to capture and review images and video collected by surgical cameras during a procedure. Once the images or video are captured they can be exported to a network, CD, DVD, or other digital media. The 640 also allows images to be printed.

Designed to be integrated into existing ORs and surgical systems, the 640 Image Management System is equipped with network capabilities via its built-in Ethernet port. Using its Integration Broker, the 640 can be integrated with Hospital Information Systems and EMR via HL7, and with PACS via DICOM. This allows patient records to be imported into the 640 from existing systems. The 640 also integrates with Smith & Nephew’s DORAWEB Surgical Documentation System to provide simple and efficient storage and access to patient information.

DORAWEB ASP (Application Service Provider) is a secure web-based surgical documentation system monitored and maintained by Smith & Nephew that offers access to patient data, template-based operative notes, and medical images. All that is required to create reports and manage images and video is a PC with high-speed internet access. This allows surgeons access to crucial data anytime and anywhere. Use of the DORAWEB ASP can help facilities to cut back on expensive hardware and reduce their IT costs.


Sony’s DVO-1000MD DVD Recorder can be integrated with many surgical and ultrasound systems.
Sony, a global leader in electronics for industry, medical and the consumer markets, currently offers a medical grade DVD-Recorder, the DVO-1000MD, designed specifically to be integrated with many surgical and ultrasound systems. It is equipped with a built in 80 GIG hard drive, enabling users to easily make referral copies of recorded sessions.

Exclusive to this compact recorder are Sony’s DVORECOVERY™ and DVOFAST™ features. Should the power go out during a surgical procedure, the DVORECOVERY feature saves the video that was being recorded, with only four seconds of video being lost. DVOFAST is a unique and valuable feature that allows healthcare professionals to record and eject a DVD of a surgery in less than 90 seconds, without having to finalize a disk. This can vastly improve workflow and eliminate costly downtime.

Sony recently introduced the DPW-120MD, a new DVD+RW disk that is pre-formatted and verified specifically for the DVO-1000MD recorder. The disk includes a stain guard, scratch guard, and static guard to protect the disk. Each disk also includes a special white label that can be written on with a standard ball point pen.

In March Sony will launch the first medical grade high-definition (HD) recorder, the PDW-70MD, utilizing Blue Ray technology. This compact full-featured recorder can record in full 1920x1080I HD resolution and will feature a built in up-converter that enables standard definition signal cameras to record an HD signal.

Many of the new Sony products designed for the medical market can be easily upgraded to offer true HD compatibility. All of Sony’s current Flat Panel Monitors can be upgraded using a simple expansion card to view HD-SDI signals. This type of architecture helps surgeons keep a system for many years while provide the most up-to-date image quality and service.


The Luxtec MicroLux DVR Digital Video Recorder.
Luxtec Corporation, another company manufacturing and marketing to the medical community, is a licensed marketer of the Sony DVO-1000MD and also offers its own MicroLux® DVR digital video recorder. The MicroLux DVR features streaming video recording in MPEG-2 format and allows for still image capture from the video. All the Luxtec video and recording products can be used in almost any surgical procedure, both in out-patient (ASC) or hospital settings. The digital video recorders can also be used to record laparoscopic, endoscopic, or microscopic procedures.


Luxtec’s MicroLux DXL headlight-mounted camera is compatible with both the MicroLux DVR Digital Video Recorder (above, left) and the Sony DVO-1000MD DVD Recorder.
Also available from Luxtec is the MicroLux® DXL headlight-mounted camera, which is compatible with both the MicroLux DVR and the Sony DVO-1000MD. This extremely small and lightweight camera provides video from the surgeon’s viewpoint without visual interference from hands or head, and features simple one touch control for improved picture quality. It also boasts 470-line resolution and hands-free auto focus with no manual adjustment required. The DLX camera can be used in telesurgical or webcast procedures.

The Thru-the-Lens “Extended-Focus” Headlight Video Camera System from BFW, Inc. offers the latest technology in surgical headlight video. A BFW exclusive, this camera is the industry’s first Coaxial Lens-to-Light Configuration, resulting in high quality, zero parallax imaging. The fully-integrated camera system is both analog and digital, and is compatible with S-VHS, DVCAM, digital camcorder, and PC or laptop computer with Fire Wire IN.

The easy to use camera system features an extended field-of-vision that maintains sharp focus from 8 inches to 36 inches throughout a surgical procedure. It also features Automatic Iris and Gain Control, and an optional zoom feature that magnifies images from four times to eight times with the touch of a keypad on the camera control unit or on a hand-held remote. It is available in both NTSC and PAL formats.


The Thru-the-Lens Headlight Video Camera System from BFW, Inc. offers the latest technology in surgical head-light video.
To eliminate Parallax, BFW developed an exclusive technology that centers the medical grade camera within their High Beam TriLens headlight. The camera and light alignment are stationary and coaxial, so what the surgeon looks at is always on camera. In addition to use in the surgical suite, teaching institutions and private practitioners can use the Thru-The-Lens Headlight Video Camera System to produce a surgeon’s eye view of any procedure for live viewing, tele-medicine, or for editing tapes and digital files for later use.

iQuire, LLC, a relative newcomer to the medical market, offers the iCap Image and Video Capture System for Windows XP. The iCap system is offered in two configurations: One is a turnkey system, a medical grade computer system that includes the computer hardware and software pre-configured. The other option is a software solution with a USB digital capture unit that can plug into an existing computer system.

With iCap, surgeons can capture still images and video clips, then easily annotate images and catalog them by an identity for easy review later. The systems can send images directly to report templates in Microsoft Word and allows images to be easily integrated into Power Point presentations and e-mail applications. And, as the system is Windows-based, it offers the user the ability to easily network multiple capture stations together with a server to create an image archival network. The images and reports are standard image files and office documents that can easily be shared via email, FTP, and easily linked to most Electronic Medical Record systems.

iQuire, LLC’s iCap Image & Video Capture System allows surgeons to capture still images and video clips, then annotate images and catalog them.
Designed to work with or without a touch screen monitor, the iCap system can be used across a variety of settings. It utilizes an icon, push-button style interface, making the system as easy to use as an ATM machine. Pushing a button on the touch screen or using a mouse to click on the button achieves a desired result. Most actions can be completed with just one or two clicks.

iQuire also offers a network application called iCap Reporter, which makes viewing and working with the iCap images and videos over the network easy. Using the same one click button design, the iCap Reporter interface is quick and easy to learn. The system works seamlessly with iCap as well as other image capture units that utilize flash memory to store captured images.

The VISERA System from Olympus is an all-in-one video system that allows connection to rigid, flexible and deflectable tip videoscopes, as well as a variety of camera heads (some autoclavable), so there is no need for multiple systems. Both still and video images are recorded digitally, making them easy to use, store, and manage. The easy to use system delivers high quality imaging and allows instrumentation for a number of clinical applications to share the same equipment. VISERA integrates all components of the imaging system from camera or videoscope to computer, and can be configured to meet the specific needs of both a clinical specialty and an individual user.


Sunoptics Surgical offers digital video recording systems in both DVD and CD formats.
Sunoptics Surgical offers digital video recording systems in both DVD and CD formats that can be used to record any video so long as the source camera outputs in a standard video format. The video systems incorporate proprietary technology that facilitates direct recording to a DVD or CD disk without the need to stream the video through a hard disk drive. They record short video strips to facilitate uploading to a PC. This also helps to minimize search time in reviewing the specific segments of the surgical record. The Sunoptics documentation system together with a video editing package supplied with each system enables a comprehensive surgical record capability. The systems accept standard video inputs and record in standard formats, providing surgeons with user friendly video records for easy editing and storage.

With the face of surgical record keeping changing, and the increased use of visual media in surgery and for medical education and consultations, the ability to capture, review, and manage images and video from surgical procedures is fast becoming critical to hospitals and ASCs as well. Fortunately, the companies that develop image and video documentation technology are keeping up with the growing demand.
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