THIS WEEK'S ARTICLES
A Smarter Way for ASCs to Operate - Sponsored Content
The Benefits of Operating in 4K
Study shows improved views of surgery lead to better results.
Surgeons who perform laparoscopic surgery with ultra-high-definition (UHD) video operate both more quickly and more safely, according to a recent study that examined the impact of higher resolution images on surgical performance and outcomes.
The researchers, who published their results online, analyzed the results of 190 laparoscopic procedures performed in the same OR to treat colorectal cancer — 94 surgeries using high-definition (HD) and 96 surgeries using UHD.
The overall complication rates for procedures performed in HD and UHD were 21.2% for the HD procedures and 17.5% for the UHD procedures. There were no statistically significant differences in rates of anastomotic leaks, post-op bleeding, mortality and readmissions. Procedures performed in HD took an average of 209 minutes to complete, compared with 193 minutes for procedures performed in UHD. Procedures performed in HD resulted in an average blood loss of 48 ml, compared with 40 ml for UHD procedures.
According to the researchers, the improved image quality afforded by UHD provides surgeons with clear views of critical anatomical landmarks, vascular structures and adipose tissue, enabling them to dissect more accurately. The researchers say more precise dissection leads to less intraoperative bleeding and shorter operative times, which reduces potential risks of complications and limits both the physiological stress of surgery for patients as well as OR costs.
Surgeons involved in the study who were surveyed said UHD video provided them with a much more detailed picture, a clearer understanding of anatomical structures and surgical planes, and less eye fatigue. "The association between quality of vision and surgical outcome is very tight," say the researchers. "Cutting-edge technologies such as UHD video allow surgeons to be even more minimally invasive."
‘Alexa, Turn Down the Music!'
Virtual assistants can help surgical teams focus during critical stages of surgery.
Many of us have grown accustomed to requesting favorite songs, making shopping lists and getting weather reports simply by calling out commands to smart speakers placed strategically throughout our homes. Now these same types of "virtual assistant" devices are finding their way into ORs.
The authors of a viewpoint published in the journal Plastic and Reconstructive Surgery say virtual assistants integrated into ORs are responding to requests during surgery — and those requests often revolve around musical volume.
Many surgeons love to have their favorite songs playing while they operate, and the authors note that ambient music has been proven to reduce muscle tension and improve efficiency during surgical tasks such as wound closure. But music can also become a dangerous distraction during emergent situations when clear communication is necessary, they say.
In those emergent situations, nonsterile personnel must pause to manually turn down music playing on a standard sound system, which wastes precious time and staff resources when seconds count. Even during non-emergent but critical stages of surgery, surgeons might hesitate to bother a team member with a request to turn off the music and decide to work through the distraction.
When music is played through a virtual assistant in the room, a member of the surgical team can pause or turn down music with a simple voice command and then quickly refocus on the task at hand. The authors say virtual assistants can be used for more than music in the OR, however, such as to set reminders about basic clinical tasks, call devices in neighboring ORs or even prompt the surgical team to complete the pre-procedure safety checklist.
"We believe the voice-controlled power that virtual assistants provide over such simple tasks make them interesting and potentially worthwhile investments in the operating room," they write.
A Smarter Way for ASCs to Operate - Sponsored Content
This video-over IP platform enables nurses and clinical staff to see the real-time status of all ORs, all in one place.
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 video surgical 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.
The video-over IP platform enables nurses and clinical staff to see the real-time status of all ORs, all in one place. And because we know operating room space and other clinical space is limited, we made the footprint minimal. There are no racks of bulky equipment or spaghetti of cables, instead we use your existing IP network infrastructure.
This affordable, modular design enables you to start with a single OR and expand to many as your needs change. Instead of locking you 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 your ASC 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.
The NUCLeUS platform features multiple apps including rotation correction, which maintains a consistent endoscope "horizon," On-screen annotation and two-way audio that enables real-time consultation. This flexible system also integrates with HIS, EMR, DICOM and HL7.
For your peace of mind, our exclusive SystemWatch® remote monitoring service helps maximize OR uptime. We monitor the NUCLeUS system 24/7 with proactive monitoring capabilities covering video sources from all connected modalities. SystemWatch can proactively detect and correct virtually any potential issue before it becomes an operational service interruption. SystemWatch maximizes uptime while greatly reducing the cost and need for onsite service technicians.
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Augmented Reality Enhances Shoulder Replacements
The technology lets surgeons follow a preplanned surgical pathway in real time.
Using augmented reality (AR) to create 3D models of a patient's specific shoulder anatomy allows surgeons to perform more precise joint replacements that could lead to improved outcomes, says Michael Khazzam, MD, an orthopedic surgeon at UT Southwestern Medical Center in Dallas, who has used the technology to perform about 30 shoulder replacements over the past six months.
Pre-op CT scans are entered into the AR platform, which creates a 3D model of the patient's joint. Dr. Khazzam uses the model to plan where he'll make incisions, insert anchors and place the implant. That process lets him develop a surgical plan based on what will work best for the patient's anatomy and pathology.
"Essentially, we can perform the entire surgery and estimate post-surgical mobility and function in virtual reality before we even touch the patient in the OR," said Dr. Khazzam. "I can show patients what we'll do prior to surgery, which helps them feel more informed and engaged in their care."
Surgeons have previously used AR to develop 3D models of patients' anatomy, which they use to plot out minimally invasive surgical approaches that preserved natural anatomy. Dr. Khazzam is taking application of the technology one step further to overlay the 3D surgical plan directly on the patient during surgery. He views the display through an AR headset to ensure the individualized surgical plan is followed precisely in real time.
"Research shows that 3D modeling can result in a highly accurate restoration of the patient's anatomy and precise positioning of the implant," says Dr. Khazzam. "AR certainly seems like a game-changing advancement for shoulder repair and replacement surgery."
Excellent Resolution Isn't All That Matters
Integrating video with OR processes can be extremely powerful.
A great surgical video system isn't necessarily just about surgeons and staff enjoying real-time, ultra-high-definition intraoperative images with excellent detail. In the next-generation OR, it's also about integrating processes and empowering surgeons and staff.
An advanced, integrated surgical video system can automatically send intraoperative images and video to an electronic medical record (EMR). It can facilitate increased communication and collaboration with providers inside and even beyond the OR.
Jocelyn Chua, RN, BSN, CNOR, executive director of surgical services, GI lab and women's health at Advocate South Suburban Hospital in Hazel Crest, Ill., and Advocate Trinity Hospital in Chicago, helped drive a two-year, eight-figure revitalization project to build nine new ORs with integration capabilities to support a growing robotics program, with ultra-high-definition video and fluorescence capabilities.
Ms. Chua raves about how her facilities' video integration systems provide for increased collaboration not only inside the OR, but beyond its walls as well. For example, during an intraoperative biopsy, her surgeons used to remove tissue and send it to pathology for dissection. The pathologist would then walk to the OR or use the phone to tell the surgeon if the sample was sufficient or if more tissue was needed. Now, thanks to cameras embedded in the OR's surgical lights, the surgeon simply shares images of the surgical field, live, with the pathologist sitting in their lab or office. "The two of them can have a conversation through the speakers in the OR about whether to finish the procedure or continue removing tissue," she says.
Another example: Previously, patient info was manually entered to tag images and videos from surgeries, and staff needed to print numerous copies of images to add to medical records for the surgeon to evaluate and to share with patients and their caregivers. Now, all images and videos are delivered straight to the patient's EMR. "When the surgery is complete and the surgeon is informing the patient's family, they've already pulled all the pictures and annotated them," she says.
Perioperative professionals must be well-versed in the capabilities and operation of video integration before they use it in live procedures, notes Ms. Chua. At her facilities, an in-service was held with a large group, followed by one-on-one trainings for each staff member. She says her tech-savvy team worked with the system on their own within a week.