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Archive September 2018 XIX, No. 9

A Closer Look at Image Enhancement Technology

Help your surgeons see the sharper clarity, contrast and detail they've been missing.

Daniel Cook

Daniel Cook, Editor-in-Chief


UMass Memorial Medical Center

ON THE BIG SCREEN Justin Maykel, MD, prefers to operate with Olympus's Visera Elite 4K ultra high-definition system. The platform lets surgeons toggle between white light and narrow band imaging, which uses filtered light to enhance the visibility of vascular structures.
Award Winner

OR Excellence Award Winner

Laparoscopic surgeons work off of visual cues. New image enhancement technology that brightens dark areas and intensifies color contrasts lets them view tissue and structures like never before and perform surgery with a level of precision few imagined was possible.

Take fluorescence imaging, for example. Anesthesia providers inject indocyanine green (ICG), a cyanine dye, into the patient and surgeons toggle the laparoscopic camera from white light to the near infrared light setting, which causes areas of blood flow in tissue to glow bright green. During bowel resection surgery, colorectal surgeon John H. Marks, MD, FACS, FASCRS, uses enhanced fluorescence imaging on Stryker's fluorescence technology to check the quality of tissue perfusion at the distal and proximal ends of the bowel before sewing them together. The imaging helps him confirm that the tissue is healthy and will heal properly, which lowers the risk of anastomotic failure.

4k Imaging
CLEARLY BETTER The 4K imaging of Arthrex's Synergy platform provides surgeons with fine-detail views of joint tissue and cartilage.

"Surgeons are often comfortable making that decision on their own without that enhancement, but there are times when truly knowing the perfusion of tissue is extremely helpful," says Dr. Marks, the director of the Colorectal Center at Lankenau Medical Center and chief of the section of colorectal surgery at Main Line Health in suburban Philadelphia.

ICG fluorescence imaging helped bariatric surgeon Kelvin Higa, MD, FACS, avoid a devastating outcome during what he thought was a routine gallbladder removal. During the case, he activated the fluorescence imaging on Karl Storz's Image1 S System and quickly realized the bile duct structures were atypical. If he had moved forward without the help of the glowing green of the contrast dye, he might not have noticed the uniqueness of the patient's anatomy until it was too late.

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