high definition laparoscopy

[spchrisk2]

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i was actually on OR Report for something else, but i saw this post about high definition laparoscopy.

http://orreport.com/archives/33

i'm not a surgeon but am curious ... are these high def scopes very common now? have any of you been using them? is there a big difference in the OR?

 

[Castro Viejo]

I don't believe they're all that common, to be perfectly honest.

I don't see the real advantage. Now if they could just make a laparoscope that doesn't fog up every five minutes, THEN they'd have a winner.

 

[Winged Scapula]

Never even heard of it and I agree with Castro: what's the point? I can see very well with the low-def except when the darn thing fogs up. FIXING THAT would be a worthwhile invention.

 

[Castro Viejo]

I remember going to a silly MIS symposium sponsored by one of the local New York medical schools and watching videos of the French and Germans dueling it out over who can do laparoscopic AAA repairs better. The videos were very impressive, to say the least, but operating with chopsticks ain't my thang.

Anyway, after the elaborate video presentations and the gripping powerpoint slides and action-packed lecture, questions from the audience were entertained. You'd expect questions on technique? Questions about the aortic cross clamp times? Patient outcomes compared to EVAR? Merits of using something stupid, like the DaVinci? No...

My attending (Chief of MIS): "Just how the hell do you guys keep your scopes from fogging up. Those pictures are absolutely amazing!" My attending is a bit of a simpleton. 😳

French Guy: "Uh, Monsieur, we, uh, how do you say? Let the gas out. Pepe Le Piu."

German Guy: "Und Ja, we let the fit-fit outtada boondoggle. Ja. Fahrvegnuggen."

Spanish Guy: "Que?"

Translation: they opened the ports to let the gas out. I've tried that. It doesn't work. "Touching something" seems to work but then everything gets blurry. FRED doesn't work. The scope warmer doesn't work. NOTHING works. Figure that one out and I'll pay whatever you want for a scope. 🙂

 

[XoQo]

I was just thinking...maybe they should build a warmer into the scope lens area. You know how your car's rear window has those conductive strips that heat up when a current is applied? Maybe make the lens a mm larger (but not changing the actual aperture size) and then place these strips within the lens material (on the inner surface of the lens).

That way, you don't hassle with FRED, the scopewarmer -- you just turn on the defogger...


granted there's probably something grand about basic optics i might be missing here about how you can't actually do this in a real 30 degree lens and how jacked up the image would be if you really did -- but hey i can daydream while waiting for my ER shift to begin right? (*grumble grumble* required rotation *grumble*)

 

[GregsAnatomy]

I've been at several hospitals that use the new HD scopes. The pictures are pretty amazing and you can see incredible detail, especially in one hospital I was at that had 42" plasma screens in the OR as well. I doubt they have any surgical advantage over standard scopes, but supposedly Ethicon will be making only HD in the future.

 

[jubb]

Just put a vent that blows across the lens to defog it. I saw a wakeboarding video where they were really close behind the wakeboarders and they used nitrogen gas to get all the splashed water off their lens. So maybe a little nitrogen vent blowing across the lens. It'd have to be nitrogen gas, not liquid nitrogen. There is nothing more frustrating than a fogged laproscope.

 

[Castro Viejo]

I've been at several hospitals that use the new HD scopes. The pictures are pretty amazing and you can see incredible detail, especially in one hospital I was at that had 42" plasma screens in the OR as well. I doubt they have any surgical advantage over standard scopes, but supposedly Ethicon will be making only HD in the future.

Ethicon makes scopes?

We recently had plasma screen monitors installed as well in the ORs here. I dunno what the heck they're for, perhaps for intended HD cameras? Anyway, the only thing we use the plasma screens for now is to have the nursing staff watch music videos and YouTube in the OR.

 

[Winged Scapula]

Ethicon makes scopes?

We recently had plasma screen monitors installed as well in the ORs here. I dunno what the heck they're for, perhaps for intended HD cameras? Anyway, the only thing we use the plasma screens for now is to have the nursing staff watch music videos and YouTube in the OR.

You guys are so hip.

We used our plasma screens at Hershey to actually pull up CT scans and the like.

 

[Blade28]

Nah, probably wouldn't need this.

 

[Castro Viejo]

You guys are so hip.

We used our plasma screens at Hershey to actually pull up CT scans and the like.

We'd probably do the same thing, but as I was told by Radiology, none of the computers in the ORs are outfitted with the necessary drivers. In due time, I suppose. Don't really care. For now, doing a colon while watching the Pussycat Dolls dance and shake their shazzams is pretty neat.

 

[Winged Scapula]

We'd probably do the same thing, but as I was told by Radiology, none of the computers in the ORs are outfitted with the necessary drivers. In due time, I suppose. Don't really care. For now, doing a colon while watching the Pussycat Dolls dance and shake their shazzams is pretty neat.

That's smart...are you sure you aren't in Jersey?

Seems like a boneheaded Jersey move.🙄

On World News Tonight: NYC surgery patient sues doctor for emotional distress at awakening during surgery and seeing him do the Macarena while removing her gallbladder.

 

[Castro Viejo]

That's smart...are you sure you aren't in Jersey?

Seems like a boneheaded Jersey move.🙄

As you may already know, having trained in the Greater New York Metropolitan Area, our little corner of New York City is about the cultural, sociopolitical, and economic equivalent of New Jersey's ******ed adopted sibling with Tay Sachs.

On World News Tonight: NYC surgery patient sues doctor for emotional distress at awakening during surgery and seeing him do the Macarena while removing her gallbladder.

My Chief got sued by a patient who said she was "emotionally distressed" after hearing him "refer to her as a pig," while he was coaching me through a CVL in the groin.

"Viejo! The patient's INR is 3.5. She'll bleed like a stuck pig if you hit the artery."

So a patient in these parts suing me for doing the Macarena while in the OR doesn't in the least bit surprise me. 🙂

 

[Winged Scapula]

As you may already know, having trained in the Greater New York Metropolitan Area, our little corner of New York City is about the cultural, sociopolitical, and economic equivalent of New Jersey's ******ed adopted sibling with Tay Sachs.

Stop insulting the Tay Sachs kids.😛

My Chief got sued by a patient who said she was "emotionally distressed" after hearing him "refer to her as a pig," while he was coaching me through a CVL in the groin.

"Viejo! The patient's INR is 3.5. She'll bleed like a stuck pig if you hit the artery."

So a patient in these parts suing me for doing the Macarena while in the OR doesn't in the least bit surprise me. 🙂

Good Lord...NOW I've heard everything!

We had to stop saying "Cow" for "Computer on Wheels" because some patient got insulted but no one ever sued. The INSANITY has to stop.

 

[Blade28]

We had to stop saying "Cow" for "Computer on Wheels" because some patient got insulted but no one ever sued. The INSANITY has to stop.

I keep advocating for penalties for people who file frivolous lawsuits (that eventually get thrown out).

 

[BlackSails]

I keep advocating for penalties for people who file frivolous lawsuits (that eventually get thrown out).

Couldnt you offer to settle for like $10, and then when they refuse, stick them with court costs?

 

[Castro Viejo]

Stop insulting the Tay Sachs kids.😛

You know the area well. 😉

We had to stop saying "Cow" for "Computer on Wheels" because some patient got insulted but no one ever sued. The INSANITY has to stop.

I was severely reprimanded during my month as the Bariatrics "Chief" as an R4 when, on rounds, we discussed "FLS." That's Fundamentals of Laparoscopic Surgery, right? One of the fattys came out and said, "I know you doctors think you can hide behind your abbreviations and $hit, so don't think I don't know FLS refers to me!"

"Just what the heck are you talking about, sir?" I asked.

"YOU just called ME a 'Fat, Lazy, Sack of $hit!'"

Gee... Someone has a self esteem issue. 🙄

 

[smq123]

We had to stop saying "Cow" for "Computer on Wheels" because some patient got insulted but no one ever sued. The INSANITY has to stop.

At our hospital, pregnant women who need to be kept for observation, but aren't in labor, are put in the "Maternity Unit," which is abbreviated as "The MU." (Pronounced "Moo.")

That is, until one of the patients said that she was pregnant, not fat, and that the med students could stop taunting her by "mooing" at her. In her words, "I ain't a COW that can be MOO-ed at!"

So we were asked to refer to the floor as the "Mom Unit." 🙄

 

[PrecordialThump]

.

 

[Castro Viejo]

That is, until one of the patients said that she was pregnant, not fat, and that the med students could stop taunting her by "mooing" at her.

Med students crack me up sometimes.

 

[smq123]

Med students crack me up sometimes.

Why? You never moo-ed at a patient? You were never even tempted to moo at your patients who need the bariatric tray for their lap appys? 😕

 

[Castro Viejo]

Why? You never moo-ed at a patient? You were never even tempted to moo at your patients who need the bariatric tray for their lap appys? 😕

No... I just remember trying to put that damn trocar in and saying, "Jesus f_cking crap, why did this bastard have to eat so damn much..."

No mooing that I remember. 🙂

 

[MossPoh]

I don't see the real advantage. Now if they could just make a laparoscope that doesn't fog up every five minutes, THEN they'd have a winner.

You mean you can't just rub toothpaste and spit on the lens like I do when I'm diving? Lame