Real-time Laparoscopic Imagery Enhancement And Clarification

Mahmoud Abu Gazala, MD, Jack Wade, Rick Hier, PhD, Randal Millar, BSEE, Chuck Siewert, BSEE, Yoav Mintz, MD

Department of Surgery, Hadassah University Medical Center, Jerusalem, Israel.

Surgical smoke and lens fogging are major hinderances to the safe and efficient course of laparoscopy. Surgeons must interrupt their work to clean lens fog or evacuate smoke that obscure their view. The ClearView Image Processor is a new device currently in preclinical trials, which uses innovative real-time image processing algorithms to address these problems. It manages to reveal hidden layers of visual information without losing any visual detail, thus providing a level of visual clarity that has never before been possible.

Description of the technology
The Zmed ClearView Image Processor is a small dedicated computer system that receives a live video stream from the laparoscopic camera, applies image processing algorithms designed to eliminate distortion and improve image clarity, and then transmits the enhanced image stream to a display monitor in the operating room. The FPGA-based image processing functions add less than a few microseconds delay to the video, which is not significant with respect to the 16.6mS frame rate of the video. Therefore, the image processing results in zero latency video delay, and images are displayed in real time.

Preliminary results
During proof-of-concept studies, surgeons reported that the ClearView was able to eliminate foggy lens problems and improve visibility through surgical smoke, and resulted in significantly better overall visibility during minimally invasive surgeries. These features allow the surgeons to continue operating even if the standard view is heavily clouded with smoke, and decreases the number of times needed to clean the lens or pause for smoke evacuation.

Conclusions / future directions
This system allows significantly enhanced visualization in laparoscopy, which may allow for safer and more efficient surgery. Enhanced imagery may additionally allow for creation of hyper-realistic imagery by adjusting contrast to exaggerate subtle textural changes in order to expose the margins between embedded blood vessels and surrounding tissue, as well as healthy tissues and diseased tissue such as tumors, which may add vital visual information to help surgeons achieve better, faster and safer laparoscopic procedures.

Session: Podium Presentation

Program Number: ET011

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