4K ultra HD technology reduces operative time and intraoperative blood loss in colorectal laparoscopic surgery

Mari, Giulio; Crippa, Jacopo; Achilli, Pietro; Miranda, Angelo; Santurro, Letizia; Riggio, Valentina; Gerosa, Martino; Ascheri, Pietro; Cordaro, Giuseppe; Costanzi, Andrea; Maggioni, Dario

doi:10.12688/f1000research.21297.1

Cited by 13 publications

(5 citation statements)

References 15 publications

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“…Relative lack of depth perception (2D view) has been a major disadvantage with laparoscopy compared to open surgery. To overcome this, 4K ultra high definition technology[ 35 ] and 3D laparoscopic technology have been introduced[ 36 ], and several trials have compared the two[ 35 , 37 ]. Neither seems superior to the other, and a recent consensus statement from the European Association of Endoscopic Surgeons concluded that further robust research is required to investigate the avantages of 3D laparoscopy system[ 38 ].…”

Section: Peri-operative Considerationsmentioning

confidence: 99%

Safety considerations in laparoscopic surgery: A narrative review

Madhok¹,

Nanayakkara²,

Mahawar³

2022

WJGE

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Laparoscopic surgery has many advantages over open surgery. At the same time, it is not without its risks. In this review, we discuss steps that could enhance the safety of laparoscopic surgery. Some of the important safety considerations are ruling out pregnancy in women of the childbearing age group; advanced discussion with the patient regarding unexpected intraoperative situations, and ensuring appropriate equipment is available. Important perioperative safety considerations include thromboprophylaxis; antibiotic prophylaxis; patient allergies; proper positioning of the patient, stack, and monitor(s); patient appropriate pneumoperitoneum; ergonomic port placement; use of lowest possible intra-abdominal pressure; use of additional five-millimetre (mm) ports as needed; safe use of energy devices and laparoscopic staplers; low threshold for a second opinion; backing out if unsafe to proceed; avoiding hand-over in the middle of the procedure; ensuring all planned procedures have been performed; inclusion of laparoscopic retrieval bags and specimens in the operating count; avoiding 10-15 mm ports for placement of drains; appropriate port closures; and use of long-acting local anaesthetic agents for analgesia. Important postoperative considerations include adequate analgesia; early ambulation; careful attention to early warning scores; and appropriate discharge advice.

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Section: Peri-operative Considerationsmentioning

confidence: 99%

Safety considerations in laparoscopic surgery: A narrative review

Madhok¹,

Nanayakkara²,

Mahawar³

2022

WJGE

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“…Technological innovations in optics and robotics help to support and improve the surgeon’s eyes and hands, and yet adverse surgical events remain an unsolved problem 1 – 3 . According to a report on human performance errors during surgery, nearly 30% of surgical complications are caused by misrecognition (MR) during operations 4 .…”

Section: Introductionmentioning

confidence: 99%

Automated segmentation by deep learning of loose connective tissue fibers to define safe dissection planes in robot-assisted gastrectomy

Kumazu

Kobayashi²,

Kitamura³

et al. 2021

Sci Rep

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The prediction of anatomical structures within the surgical field by artificial intelligence (AI) is expected to support surgeons’ experience and cognitive skills. We aimed to develop a deep-learning model to automatically segment loose connective tissue fibers (LCTFs) that define a safe dissection plane. The annotation was performed on video frames capturing a robot-assisted gastrectomy performed by trained surgeons. A deep-learning model based on U-net was developed to output segmentation results. Twenty randomly sampled frames were provided to evaluate model performance by comparing Recall and F1/Dice scores with a ground truth and with a two-item questionnaire on sensitivity and misrecognition that was completed by 20 surgeons. The model produced high Recall scores (mean 0.606, maximum 0.861). Mean F1/Dice scores reached 0.549 (range 0.335–0.691), showing acceptable spatial overlap of the objects. Surgeon evaluators gave a mean sensitivity score of 3.52 (with 88.0% assigning the highest score of 4; range 2.45–3.95). The mean misrecognition score was a low 0.14 (range 0–0.7), indicating very few acknowledged over-detection failures. Thus, AI can be trained to predict fine, difficult-to-discern anatomical structures at a level convincing to expert surgeons. This technology may help reduce adverse events by determining safe dissection planes.

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“…Regarding operation needs, it has been shown that 4 K ultra HD monitors reduce operative time and intraoperative blood loss in colorectal laparoscopic surgery, so these technologies with higher quality should be widely incorporated in clinical settings for the normal colonoscopy practices, since currently these 4 K ultra HD technologies are mainly available in specialized, high-volume laparoscopic centers [ 79 ]. However, the reduction of operative time achieved with these technologies should be taken with caution, as acting quickly with a shorter withdrawal time is also associated with higher interval CRC rates [ 80 ].…”

Section: Discussionmentioning

confidence: 99%

Medical needs related to the endoscopic technology and colonoscopy for colorectal cancer diagnosis

et al. 2021

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Background The high incidence and mortality rate of colorectal cancer require new technologies to improve its early diagnosis. This study aims at extracting the medical needs related to the endoscopic technology and the colonoscopy procedure currently used for colorectal cancer diagnosis, essential for designing these demanded technologies. Methods Semi-structured interviews and an online survey were used. Results Six endoscopists were interviewed and 103 were surveyed, obtaining the demanded needs that can be divided into: a) clinical needs, for better polyp detection and classification (especially flat polyps), location, size, margins and penetration depth; b) computer-aided diagnosis (CAD) system needs, for additional visual information supporting polyp characterization and diagnosis; and c) operational/physical needs, related to limitations of image quality, colon lighting, flexibility of the endoscope tip, and even poor bowel preparation. Conclusions This study shows some undertaken initiatives to meet the detected medical needs and challenges to be solved. The great potential of advanced optical technologies suggests their use for a better polyp detection and classification since they provide additional functional and structural information than the currently used image enhancement technologies. The inspection of remaining tissue of diminutive polyps (< 5 mm) should be addressed to reduce recurrence rates. Few progresses have been made in estimating the infiltration depth. Detection and classification methods should be combined into one CAD system, providing visual aids over polyps for detection and displaying a Kudo-based diagnosis suggestion to assist the endoscopist on real-time decision making. Estimated size and location of polyps should also be provided. Endoscopes with 360° vision are still a challenge not met by the mechanical and optical systems developed to improve the colon inspection. Patients and healthcare providers should be trained to improve the patient’s bowel preparation.

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4K ultra HD technology reduces operative time and intraoperative blood loss in colorectal laparoscopic surgery

Cited by 13 publications

References 15 publications

Safety considerations in laparoscopic surgery: A narrative review

Safety considerations in laparoscopic surgery: A narrative review

Automated segmentation by deep learning of loose connective tissue fibers to define safe dissection planes in robot-assisted gastrectomy

Medical needs related to the endoscopic technology and colonoscopy for colorectal cancer diagnosis

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