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Live video manipulator for endoscopy and natural orifice transluminal endoscopic surgery (with videos) - 23/08/11

Doi : 10.1016/j.gie.2008.04.018 
Shou-jiang Tang, MD , Richard Bergs, MS, Saad F. Jazrawi, MD, Christopher O. Olukoga, MD, Jeffrey Caddedu, MD, Raul Fernandez, PhD, Daniel J. Scott, MD
Current affiliations: Division of Digestive and Liver Diseases, Department of Internal Medicine (S.-J.T., S.F.J.), Department of Surgery (C.O.O., D.J.S.), and Department of Urology (J.C.), University of Texas Southwestern Medical Center, Dallas, Texas, USA, Texas Manufacturing Assistance Center, Automation and Robotics Research Institute, University of Texas (R.B., R.F.), Arlington, Texas, USA 

Reprint requests: Shou-jiang Tang, MD, Parkland Memorial Hospital, Division of Digestive and Liver Diseases, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75390-9151.

Dallas, Arlington, Texas, USA

Abstract

Background

During fluoroscopy, radiologists and gastroenterologists are able to manipulate live fluoroscopic video for better orientation and visualization. During endoscopy and natural orifice transluminal endoscopic surgery (NOTES), this function is not currently available. Particularly during NOTES, the endoscopic image is sometimes inverted, and off-axis operation is required.

Objective

Our purpose was to develop and test a prototype live video manipulator (LVM) for endoscopy, laparoscopy, and NOTES.

Design

Prospective ex vivo and in vivo feasibility study.

Interventions

We developed a prototype LVM software for video image manipulation that can be easily installed on any computer. The video input is streamed into the computer and can be displayed on a standard monitor. LVM was tested ex vivo in the following functions: (1) instant live video rotation, (2) vertical or horizontal video inversion, (3) mirror imaging, and (4) digital zooming. These functions were also tested during upper and lower GI endoscopy, ERCP, diagnostic laparoscopy, and various transvaginal NOTES procedures (cholecystectomy, gastroenterostomy, and sleeve gastrectomy) in porcine models.

Main Outcome Measurements

Image quality observation between unmanipulated and manipulated live videos.

Results

LVM reliably and easily performed live video manipulation during these tests. Besides standard definition video signals, LVM is fully compatible with high-definition video endoscopy. Three observers reported that the subjective image quality was the same in specified areas between manipulated and unmanipulated live videos.

Limitations

Observation and feasibility study.

Conclusions

LVM reliably and conveniently performed live video manipulations. LVM requires minimal equipment, capital investment, and maintenance, and is easy to set up. LVM can be a useful tool in many medical imaging studies, including endoscopy, laparoscopy, and NOTES, either as a built-in technology or as an as-needed add-on feature.

El texto completo de este artículo está disponible en PDF.

Abbreviations : LVM, NOTES


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© 2008  American Society for Gastrointestinal Endoscopy. Publicado por Elsevier Masson SAS. Todos los derechos reservados.
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Vol 68 - N° 3

P. 559-564 - septembre 2008 Regresar al número
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