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Archive Hot Technology 2017

The Clear Choice in Surgical Video

Standard high-def is becoming passé as progressive facilities outfit their ORs with the latest in 4K imaging.

Diane Stopyra

Diane Stopyra


Jason Dierking, MD SHARPER IMAGE Jason Dierking, MD, was thrilled when 4K imaging was added to the ORs at Buena Vista Regional Medical Center in Storm Lake, Iowa.

The gallbladder was gangrenous, bleeding, inflamed and draining pus. Brian Smith, MD, MSBS, FACS, a general surgeon at Physicians Regional Medical Center in Naples, Fla., didn't think there was any way he'd be able to see well enough to remove it laparoscopically. Luckily, Physicians Regional had recently upgraded its imaging technology to ultra high-definition video, the new frontier in laparoscopic and arthroscopic visualization. The challenging gallbladder resection was Dr. Smith's first surgery with the new system. He was able to avoid converting the case to an open procedure, thanks to the crystal clear images splashed across the OR's monitor, and quickly became sold on the imaging technology that's giving surgeons a glimpse at surgery's future.

The picture of safety
4K is short for four thousand, as in 4,000 pixels of horizontal resolution, a number that's 4 times greater than what you'd experience with full HD. That translates to a clearer picture with greater depth of field. On top of that, the color gamut (especially for reds and yellows) is heightened, meaning diagnostic decisions based on a tissue's shade can be made with greater confidence.

"Those factors make it easier to tell what I'm looking at on the monitor," says Dr. Smith. "It's easier to distinguish between normal and pathological anatomy, to identify structures that I need to target and to see through bloody fields."

This improved visualization means tiny branch vessels and capillaries can be identified and avoided altogether, or cauterized and clipped to stop bleeding. Previously, surgeons may have missed such things, bluntly dissecting through them. In other words, 4K allows for a more refined surgical approach.

The 5 mm scopes used with 4K imaging allow for smaller incisions (read: less chance of bleeding, infection and hernia) than the 10 mm scopes of the past. According to a study published in the Journal of Minimal Access Surgery, the rate of complication after conventional laparoscopic surgery is about 21 per 100,000 cases, and increases in proportion to the size of the port site incision (

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