High-definition telemedicine

Jul 18 2007

As a surgeon performs a minimally invasive procedure at Cedars-Sinai Medical Center in Los Angeles, surgeons observing in Boston or Mexico City or London will notice a remarkable improvement in clarity, compared to the view they would have had in the past.

Cedars-Sinai has placed the most advanced high-definition cameras in two of its state-of-the-art operating rooms that are equipped to transmit images and audio in real time around the world for educational purposes. The miniaturized cameras are mounted at the ends of laparoscopes, instruments that enable surgeons to maneuver and operate inside a patient's body through very small incisions.

“Our surgeons are often invited to teach at international conferences, and the best way to teach, of course, is to be virtually there from the operating room,” said Edward H. Phillips, M.D., executive vice chairman of Cedars-Sinai's Department of Surgery and chief of General Surgery. Cedars-Sinai is home to several pioneers in minimally invasive techniques, and the cameras are unlike any others in the Los Angeles area.

The high-definition cameras, manufactured by Karl Storz, one of the most respected producers of precision instruments and equipment, offer several benefits for surgeons performing operations and those viewing a procedure at another location.

“Hemoglobin from blood absorbs light, and the present analog systems do not compensate well for this decrease in illumination. Also, red color saturation is less in high definition. The end result is that high definition enables the surgeon to see better when there is blood in the surgical field, which makes surgery safer,” said Phillips, who holds the Karl Storz Endowed Chair in Minimally Invasive Surgery in Honor of George Berci, M.D., one of the developers of minimally invasive techniques and technology.

With the new cameras, surgeons can view the surgical field even when using a smaller diameter scope, which translates into smaller incisions and reduced pain. High definition also provides a wide-angle view, which allows surgeons to more quickly see instruments moving in and out of the surgical field, and depth of field is improved.

“You're looking at a two-dimensional monitor but the visual clues that we use to judge depth of field, such as shadow and parallax – where a closer item appears bigger than one farther away – can be seen more clearly. We have shown in the surgical training lab that certain functions, such as tying knots and suturing, are improved because of the enhanced depth of field. There is less of what we call “sword fighting,” or moving around instruments before getting to the target,” Phillips said.

Widely known for his expertise in minimally invasive procedures, Phillips and his colleagues recently completed a study on the use of high-definition cameras in laparoscopy and expect to publish their results in the near future.

The operating rooms housing the new cameras are designed to provide X-rays and other images, data, and the most sophisticated technology at the surgeon's fingertips.

The first in Southern California and one of only 10 hospitals in the state whose nurses have been honored with the prestigious Magnet designation, Cedars-Sinai Medical Center is one of the largest nonprofit academic medical centers in the Western United States. For 19 consecutive years, it has been named Los Angeles' most preferred hospital for all health needs in an independent survey of area residents. Cedars-Sinai is internationally renowned for its diagnostic and treatment capabilities as well as breakthroughs in biomedical research and superlative medical education. It ranks among the top 10 non-university hospitals in the nation for its research activities and is fully accredited by the Association for the Accreditation of Human Research Protection Programs, Inc. (AAHRPP). Additional information is available at