general surgery, we operate around very small nerves, which, if
nicked, could harm a patient's sexual performance or bladder func-
tion. To see those nerves in greater detail could improve outcomes
and quality of life."
• Image enhancement. During Dr. Smarr's surgery, Dr.
Ramamoorthy used green-contrast imaging and fluorescein dye to
visualize blood flow in the tips of the resected colon to determine
where it would be best to reattach the ends. Some imaging systems
also have integrated platforms that automatically brighten dark areas
of video images and heighten color contrasts and the natural color of
anatomy, so surgeons can more easily identify nerves, blood vessels
and tissue.
"Many surgeons believe they can differentiate structures and tell
how well tissue is perfused with the naked eye," she says, "but there
are subtleties that image enhancement and lighting up the tissue [with
dye] can identify."
• Big-screen surgery. Video monitors are stretching beyond 55 inch-
es and feature tiling displays that let you show several images at once,
including CT scans, live laparoscopic views of surgery and vital signs
readings.
During Dr. Smarr's robotic procedure, the OR team was fascinated
with the live video feed that was routed to a large wall-mounted moni-
tor. The 3D model of the colon displayed next to the laparoscopic
camera feed gave them situational awareness that they can't get by
watching surgeons manipulate instruments on a standard-sized
screen.
"I love the big monitors," says Dr. Ramamoorthy, who finds that her
surgical team and anesthesia providers are much more engaged dur-
ing procedure because they can follow the action more closely and in
greater detail.
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