See What's New in Surgical Video

A successful imaging upgrade largely depends on how you approach the vendor-selection process. That means you need to do the bulk of your research well before you reach out to manufacturers of video equipment, so you know what you're looking for and what they can provide. It's also a good idea to limit your search to no more than four companies to avoid feeling overwhelmed with the options. "We worked with three different vendors that we trialed over the course of several months," says Mr. Kaczmarek.

In the end, if you're routing a lot of different equipment through your visualization system, having a single, reliable vendor may be the deciding factor. "As an orthopedic surgeon, I use a lot of different equipment — pumps, radiofrequency devices, burrs, shavers and more," says Shane J. Nho, MD, MS, FAAOS, sports medicine specialist at Midwest Orthopaedics at Rush in Chicago, Ill. "Ideally, I want one video system to plug into and out of, not different sources [to manage]."

Vendor reps ultimately determine how quickly you can get your new system up and running. "They can save you a ton time or cost you a ton of time," says Dr. Nho. "You really do rely on your vendors as much as any other personnel in the OR."

Indeed, the vendor rep who worked with Ascension was a critical part of the OR team. "Our vendor provided real-time, on-site support for a full 90 days after we went live with our upgrades," says Mr. Kaczmarek. "I didn't know we would need this amount of support when we were trialing vendors, but I'm certainly glad we had it."

Don't be afraid to set clear expectations about what you expect from a vendor when adding imaging technology. In other words, make it clear to the rep that you expect the upgrade process to be as seamless as possible because surgeons won't have a lot of patience for disruptions to their block times, and you need to keep revenue-generating cases moving through your facility. Excessive downtime isn't an option, and the clearer you are about this expectation, the more smoothly the upgrade will go, says Dr. Soans.

There's no way around the large upfront investment of upgrading your visualization system, but, just as in the consumer market, 4K prices have dropped significantly in recent years. Some vendors offer a managed equipment services agreement, which is structured a lot like a financing option.

Essentially, facilities can opt to pay for the service and technology over time instead of all at once.

There are also some proven ways to ensure you get the best deal possible for your facility. "If you have a preferred vendor your facility uses, but they're not giving you the best pricing on 4K, use the other vendors to help you get a better quote," says Dr. Nho. Plus, as Dr. Nho points out, a lot of vendors are looking for contracts on implants and disposables and are willing to provide towers and monitors for a nominal cost if you sign exclusive instrument and implant contracts.

Ultra-high-def laparoscopes now come in a 5 mm size, a reduction from the larger 10 mm option, that allows surgeons to operate through smaller incisions. Smaller isn't always better, however. Downsized images on scopes with inferior light sources could appear dark and dull. That's wasn't the case with Ascension's 4K system. In fact, some of the general surgeons have commented that 5 mm scopes are almost comparable to the 10 mm models, says Mr. Kaczmarek. Now they're able to use the smaller scope on more procedures involving smaller incisions, he adds.

Many imagining systems are also integrated to improve workflow in your facility. "Our video images are integrated into one big system," says Mr. Kaczmarek. "It allows us to do CT scans, X-rays, MRIs and real-time ultrasound, and pipe that imaging to any of the screens in our ORs, so those crisp 4K images and video are right in front of our physicians as well as nurses and other staff."

While many facilities have yet to make the switch to 4K, there's already talk of the surgical application of 8K technology's 7680 x 4320-pixel matrix. And rightfully so. Research shows this emerging technology could help surgeons perform complex, minimally invasive procedures (osmag.net/Q4FnBx).

When Ascension upgraded to 4K in 2019, it positioned itself for the next upgrade it would need by working with a video vendor who offered a modular form of technological architecture ("backwards and forwards compatible") designed to make it easier to seamlessly add new imaging technologies like 8K as they become available. His facility's new imaging system is designed to only have to upgrade the components that handle the 8K images instead of overhauling the entire infrastructure to make the switch.

"We don't know exactly what 8K will look like, but when it comes out, we'll be ready," says Mr. Kaczmarek.

With all the inherent benefits of 4K visualization, it's becoming more difficult to put off making the upgrade, especially if you're building new ORs or renovating your current ones. "What we can do as surgeons largely depends on how well we see the surgical field," says Dr. Soans. As a facility leader, your goal is to help them operate better by giving them the best possible views of surgery. OSM