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Universal multifunctional HD video system for minimally invasive open and microsurgery

Abstract

Background

Laparoscopy has familiarized most surgeons with the benefits of a surgical video system, including the ability to magnify fine structures, to display the operative field on a monitor for improved intraoperative communication, and to capture video footage for documentation and education. Use of intraoperative video systems during open surgery is far less common and the potential benefits of this have not been well explored. In this report we describe a simple video system that is applicable to both laparoscopic and open surgery.

Methods

We employed a standard laparoscopic HD camera (1080p) and telescope for initial laparoscopy. In cases requiring laparotomy, a mechanical arm is attached to the operating table and the camera is mounted without the telescope; this provides video display of the open surgical field. In cases requiring dissection or anastomosis of minute structures, a prototype telescope made for open cases is attached to the same camera; this provides improved magnification and illumination for the surgeon. Microsurgical components can then proceed with the surgeon working off the video monitor at a more convenient posture and with the benefits of video display.

Results

This multifunctional HD video system for open abdominal surgery has been utilized in 98 complex hepatopancreaticobiliary surgeries. Clear benefits include (1) improved intraoperative communication, (2) improved teaching of bystanders, (3) improved visualization of minute structures, and (4) improved capture and utilization of surgical video and images for education. In an analysis of patients who underwent pancreaticoduodenectomy (PD) with this system, there was a trend toward fewer pancreatic leaks and shorter length of stay but slightly longer operative time compared to PD prior to implementation of this system.

Conclusions

This system can be employed with little added cost over a standard laparoscopy setup and has the potential to be widely utilized in surgical education programs.

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References

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    Nissen NN, Menon V, Williams J, Berci G (2011) Video-microscopy for use in microsurgical aspects of complex hepatobiliary and pancreatic surgery: a preliminary report. HPB (Oxford) 13(10):753–756

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    Mamelak AN, Nobuto T, Berci G (2010) Initial clinical experience with a high-definition exoscope system for microneurosurgery. Neurosurgery 67(2):476–483

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Disclosures

James Williams received salary support in part from a grant from Karl Storz, Endoscope, Inc., and George Berci received grant support and consultation fees from Karl Storz, Endoscope, Inc. Nicholas N. Nissen, Vijay G. Menon, and Steven D. Colquhoun have no conflicts of interest or financial ties to disclose.

Author information

Correspondence to Nicholas N. Nissen.

Additional information

Presented at the SAGES 2012 Annual Meeting, San Diego, CA, March 7–10, 2012.

Electronic supplementary material

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Supplementary material 1 (WMV 21888 kb)

Supplementary material 2 (WMV 38927 kb)

Supplementary material 3 (WMV 38521 kb)

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Nissen, N.N., Menon, V.G., Colquhoun, S.D. et al. Universal multifunctional HD video system for minimally invasive open and microsurgery. Surg Endosc 27, 782–787 (2013). https://doi.org/10.1007/s00464-012-2552-5

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Keywords

  • Hepatopancreaticobiliary
  • HD video system
  • Minimally invasive open surgery
  • Microsurgery