THIS WEEK'S ARTICLES
OR Integration Designed for the ASC - Sponsored Content
The Power of Video Integration
A well-designed video system is physically out of the way of surgeons and staff — and can connect remote providers to the OR.
The size and resolution of surgical displays are crucial in today's ORs, but the real power of modern video systems lies in how they can integrate seamlessly with other platforms to provide valuable functionality to surgeons and staff.
Jennifer Milam, MSN, RN, NE-BC, director of perioperative services at Ochsner Medical Complex - The Grove, a recently opened five-story medical complex and surgical hospital in Baton Rouge, La., envisioned the possibilities of video integration in the facility's four new ORs when she joined Ochsner. "Surgery has made a massive movement toward minimally invasive procedures, so video technology is absolutely critical to everything we do," she says. "We were very fortunate to get site visits and see what a demo facility looked like and what top-of-the-line equipment looks like, so we could make an educated decision."
When exploring OR video integration, Ms. Milam recommends taking your time and looking at vendors beyond your usual partners in order not to miss out on the latest innovations and capabilities. She also advises getting surgeons and staff involved in the trialing process. "Make sure the people who do the work get the opportunity to see the tech in action," she says. "As a leader, what I see as bright, shiny and fantastic may not function as well once they put it into practical application."
Ms. Milam says video integration wouldn't have been possible in the older, smaller ORs in which she's worked. "Our new rooms are built to accommodate surgical robots and microscopes, which take up a large footprint," she says. In each OR, two large monitors hang on separate walls, while another two are mounted on boom arms that can be repositioned around the surgical field for optimal viewing.
The video equipment in Ms. Milam's new ORs is portable and consumes exactly zero fixed floor space. "If you're performing a procedure that doesn't require video equipment, it can be swung around and moved up against the wall where it's not in the way," she notes. "All the pieces we need for laparoscopic procedures or any type of surgery involving video imaging are on the booms, so the floors are clear of cords and clutter."
At Ms. Milam's facility, thanks to video integration, surgeons in different ORs can consult while performing surgeries. "For example, a GYN surgeon working in one OR and a general surgeon working in another can share video images in real time on each other's screens and discuss what they see," she says. Her facility has also used video integration to show live surgeries in its conference rooms for teaching purposes.
Three Powerful Aspects of Surgical Video Systems
These features and requirements might not be top of mind, but they have the potential to transform surgery for the better.
The crystal-clear resolution and enhanced imaging delivered by a good surgical video system allow surgeons to better visualize tissue and make improved clinical decisions. Vendors are adding compelling bells and whistles to imaging platforms that further enhance surgeon performance.
Suraj Soudagar, MS, MBA, LEED AP, principal and project executive in the healthcare unit of IMEG, a design and engineering consulting firm in Naperville, Ill., touches on three powerful features and concepts that surgical administrators should consider when evaluating modern surgical video systems:
Dynamic response. This useful feature automatically brightens or dims light while the surgeon navigates within the surgical cavity. "Dynamic response is similar to the technology that automatically lowers a car's high-beam headlights when another car comes into view," says Mr. Soudagar. "Surgeons benefit from dynamic response on their scopes' cameras because too much light reflection can create a blinding effect. On the flip side, the technology automatically brightens the surgeon's view if there's too much darkness within the surgical cavity to properly navigate or identity critical structures."
Video management. Image editing, retrieval and storage capabilities are important components of an advanced surgical video system. "Determine how important video capture and storage are to your surgeons," says Mr. Soudagar. "One terabyte of storage capacity is generally a good starting point with 4K systems, although be prepared to expand that capacity in the future."
Infrastructure. Mr. Soudagar says the amount of data transferred from the latest surgical video systems to internal networks and EMRs is a guaranteed bandwidth hog on a facility's data network. "Standard copper wires are an inadequate conductor for large 4K images, which degrade after they pass through 300 feet of the wire," he says. Upgrade your video network from copper wire to fiber optic cables, suggests Mr. Soudagar. "This will require an upfront cost," he says, "but it's an investment well worth making because upgrades you make five or 10 years from now will then truly be plug-and-play."
Mr. Soudagar says surgical facility leaders should perform a deep dive to determine exactly what their facilities need and want out of these increasingly versatile systems before they make an investment.
OR Integration Designed for the ASC
The benefits of optimizing OR scheduling, cleaning protocols and turn-around time for real-time status.
Sony's NUCLeUS OR Integration solution, designed specifically for Ambulatory Surgery Centers (ASCs), uses Video-over-IP technology to streamline every phase of the imaging workflow from surgical video capture, recording and sharing — without complex point-to-point wiring or time-consuming reconfiguration. Surgical teams and clinical staff can route multiple sources to any destination within the facility and optimize OR scheduling, cleaning protocols and turn-around time to better prepare for the next procedure and provide insight into the real-time status of all ORs, all in one place.
The affordable, modular design of NUCLeUS enables users to start with a single OR and expand to many as needs evolve. Instead of locking users into one modality or one type of procedure, the system supports a variety of modalities such as endoscopic, ultrasound, C-arm, 3D robotic and anesthesia systems. This helps make ASCs reconfigurable for all needs — today and tomorrow — and the system can accommodate virtually any image modality at up to 4K resolution over copper or fiber IP networks, ideal for new builds or retrofitting older facilities.
NUCLeUS is already in use by leading healthcare professionals worldwide who are experiencing its numerous benefits and efficiencies. Dr. Marc Dean, who is a board-certified otolaryngologist specializing in ear and sinus disease and disorders of the eustachian tube in Fort Worth, Texas, has transformed his workflow using NUCLeUS.
He explains, "As I looked for an ideal OR Integration system for my new clinical innovation center, I knew I needed a flexible solution that would accommodate the needs of an outpatient surgery center, while also enhancing my ability to share surgical video to instruct other surgeons."
"When I was introduced to Sony's NUCLeUS smart Video--ver IP imaging platform, I immediately recognized the numerous advantages it offered both inside and outside my facility. It's an incredibly agile and easy to use system that allows me to securely record, stream, edit, share and retrieve content from multiple video sources and locations across my facility. This has helped me created an efficient and streamlined workflow. With NUCLeUS, I can collaboratively train and educate partners and the next generation," says Dean.
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Technological Advances Enable Remote Surgeries
Surgeons can now operate on patients from anywhere in the world.
Remote surgery is now possible thanks to the digital capabilities of audio, video, global networking and robotic assistance. Advanced OR video integration systems and high-speed networks help connect surgeons anywhere in the world to patients at remote surgical facilities.
A recent paper in the journal Cureus reviewed the benefits and limitations of this tantalizing possibility. "The future of surgery is transforming with the integration of new technologies such as the 5G internet, artificial intelligence, haptic feedback technology, 3D printing and nanotechnology," write the authors, who say the benefits of remote surgery include:
No long-distance travel. Remote surgery alleviates the need for patients to travel beyond their local area to access the specialized surgical care they need.
Equity in health care. Surgeons in large cities or advanced economies can perform procedures on patients in medically underserved communities or nations.
Real-time collaboration. Surgical experts from various healthcare centers around the country and the world can team up to improve patient care.
Mitigating surgeon shortages. Facilities having a difficult time recruiting talented physicians locally or regionally could connect with providers in other cities or countries to provide care.
The authors believe that the continued deployment of super-high-speed 5G networks, haptic feedback robotic technology that mimics surgeons' natural hand movements and allows them to "feel" the instruments they are using, artificial intelligence and augmented/virtual reality capabilities make adoption of remote surgery inevitable over time.
In the Market for Surgical Video Monitors?
Pretty pictures and display dimensions aren't all that matter.
Finding the right video monitors for your facility's ORs requires looking beyond image quality or screen size. Here are several factors to consider when evaluating your options.
Connectivity. Monitors must attach to the video sources your surgeons use to create video images. Will your endoscopic cameras, for example, connect to the monitor? Remember also that a full chain of 4K video components is required to realize the benefits of a 4K monitor.
Ergonomics and safety. To avoid provider injury or damage to the monitor, consider safety features. Many new monitors come with panels that protect screens from scratches and splashes, or rounded corners and bumper guards that soften blows from accidental bumps. To prevent slips and trips on cords, many monitors offer cable management features that keep wires out of high-traffic areas.
Visibility. Many vendors offer anti-reflective coatings for their screens to prevent glare from surgical lights. Features such as brightness, contrast ratio and response time can also improve image clarity and visibility. Viewing angle, which is 178 degrees in many new monitors, describes how well multiple providers in the OR can view the screen at the same time. Look for full image integrity from virtually any angle, enabling members of the surgical team to see images just as well as the surgeon.
Cleaning. Vendors are increasingly focused on making monitors easier to wipe down, clean and disinfect during room turnovers. New features include smaller or nonexistent ventilation holes as well as edge-to-edge glass and completely flat surfaces.
Advanced features. A growing number of new monitors provide image-enhancement features for even better clinical views. These include 3D capability, the ability to rotate, resize or otherwise customize images on the fly, and tiled displays that allow for simultaneous viewing of two or more images side by side in equal proportion or in various sizes.
Keep in mind that some vendors focus only on selling monitors, while some sell their own or third-party monitors as part of larger video integration systems. As with any negotiation, learn about each vendor's repair services, maintenance contracts and warranties.