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Instrumentation for laparoscopic surgery in 2014

D Mutter, MD, PhD, FACS
Epublication WebSurg.com, Dec 2014;14(12). URL: http://websurg.com/doi/lt03enmutter012

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  • 2014-12-15
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The performance of surgical procedures using laparoscopy changes the surgeon’s vision of the operative field. The surgeon works with direct vision using a monitor, hence visualizing the operative field in optimal conditions. The surgeon’s working space is limited to the abdominal cavity, and the surgeon no longer has to focus on the entire operating theater. This implies that an original operative area made up of the abdominal cavity, for digestive surgeons, must be created. The creation of this working space is achieved by means of controlled carbon dioxide insufflation into the abdominal cavity. The operative image will be conveyed once the operative field has been lit up using a white light source (named cold light as it provides a 6000K color corresponding to sunlight color). The image is first captured by a camera which transforms colors into digital data through Charge-Coupled Device (CCD) captors. It will then be transmitted through a digital screen. This method of image creation depends on the quality and technique of each part of this chain. The quality of surgical video images has evolved rapidly over the years as there have been tremendous advances in computer science and video technologies. In 2014, the current standard is the HD camera, which conveys an accurate image through a HD monitor. Scopes have been steadily improving, image quality has been enhanced, especially when it comes to brightness and definition. Tomorrow, the image will be stereoscopic and 4K, hence pushing the standards of image-guided surgery forward. All the components of this "image sequence" will be taken into consideration in order to offer surgeons not only the possibility to have basic knowledge of instrumentation to maximize their choice of brand-new armamentarium but also to understand the technical malfunctions likely to alter surgical image quality so as to make up for such shortcomings.