The Smart Magazine About Medical Technology Innovations

#25 - Live From MEDICA

Integrated Operating Rooms

An OR calm, clean, and integrated (Courtesy of OPTIMUS).

Operating rooms are now more and more “integrated”, with improvements in high-resolution imaging equipment and the enhanced ability to use large amounts of visual OR data.


What does “integrated” refer to? It means that all the operating room technology—patient information systems, audio, video, lighting and medical equipment—is functionally connected, enabling a surgeon to control all these devices from a single touch screen.

“At the moment, innovations for interventional procedures are seen as particularly important. In the case of modern surgery procedures, an ‘integrated’ approach is in demand,” said Joachim Schäfer, managing director of Messe Düsseldorf, host to the MEDICA conference. According to David Delgado, Product Manager at Olympus, “integrating all aspects of control within the operating room through a simple user interface with quick access to presets such as surgical lights and insufflations, will help standardize workflow and provide more patient care during surgery.”

Sam Glassenberg, founder and CEO of Level EX, the Chicago-based developer of surgical training apps, said the primary driver for new, integrated OR technology is minimally invasive surgery. “By performing these procedures via remote camera/endoscope, doctors can achieve improved patient outcomes with fewer complications,” he explained. “As these procedures become more advanced, surgeons will find additional data and visualization overlaid on screens, and eventually on artificial reality displays. The dimensions of control and degrees-of-freedom will increase, as will precision in all dimensions, including depth.”

4K Resolution is One of the Keys

FSN manufactures medical-grade LCD monitors, medical digital video recorders, matrix switchers, wireless HD video transceivers and related gear.

Michael Foldes, Eastern Region General Manager, told us that whether an OR is well-integrated or not depends on the systems being used. “Routing vital functions information to the video display can go either through a distribution system or directly from the data acquisition device, such as an endoscope or C-Arm, to a video display monitor where the OR team and physician can see it,” he said. “Where and how it can be stored also can make a great deal of difference.”


Merivaara OpenOR system (Courtesy of Merivaara).

An increasingly important key to these integrated systems is recording and archiving equipment offering 4K resolution, four times greater than standard high-definition video.

Jyrki Nieminen, director of R&D at Merivaara, Finland-based developer of operating room equipment and integration systems, noted that “4K camera heads are getting a lot of sales because the color spectrum they can offer to the surgeon is much wider and much deeper than in a full HD camera. In other words, the surgeon can see even deeper red colors on the screen. That’s what they want—more detail and better color.”

In real life, if you give surgeons the option, they will never choose full HD any more if they can have 4K.

He said the ability to discern different shades of red in tissue can help surgeons make clinical adjustments. “It’s pretty crucial information. In real life, if you give surgeons the option, they will never choose full HD any more if they can have 4K.” Four years ago, Merivaara introduced its OpenOR system for still and video imagery. It is currently available in Europe, Asia, Africa and Central and South America, but not yet in the United States.

Jordan Sylvester, Vice President, Global Marketing at STERIS explained to us that “4K and high-resolution imaging in the OR helps surgeons to more readily discern anatomic borders and improve visibility of fine detail – ultimately, to improve visual confidence, reduce eye fatigue, and support informed treatment decisions to deliver better surgical outcomes.”

8K is Just Around the Corner

What does the future hold? Experts agree that image quality will keep increasing, a plus for both surgeons and patients. According to Nieminen, “Image resolution will rise. We have 4K images and 8K is already around the corner. It is important for hospitals to use systems like ours to prepare for the future.”


8K is around the corner – Siemens has developed an innovative rendering algorithm that provides superbly detailed, photorealistic images (Courtesy of Savvas Nicolaou, Vancouver General Hospital).

He also noted that insurance companies favor systems like OpenOR that track what happened in the operating room.

It would not surprise me if surgeons one day have very high-definition flexible displays on their forearms to see what’s going on inside a patient.

FSN’s Foldes added, “In places that can afford it, I would say there will be hybrid ORs with larger, higher definition video displays that allow 8, 12, or even more images to be displayed and switched simultaneously, on one or more large-screen displays.”

“It would not surprise me if surgeons one day have very high-definition flexible displays on their forearms to see what’s going on inside a patient when they’re doing minimally invasive surgery, instead of having to look up at a screen hanging above or outside the operating theater.” The rest of the staff would watch the monitors.

LevelEX’s Glassenberg envisions surgeons using integrated ORs to audition minimally invasive surgical devices and techniques in a virtual environment before using them on real patients. “The extreme resolution offered by retina-class displays on modern phones and tablets enables the recreation of upcoming generations of HD endoscopes in a virtual surgery environment,” he said.

About the Author

Howard Wolinsky is a Chicago-based freelance journalist specializing in health-care topics.

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