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surgery isn't only about electronic imaging technology. Sometimes it involves a comparatively low-tech assist from handheld tools. The miniaturization of instruments has brought about retractors that can fit through smaller trocars to lift soft tissue structures out of the surgeon's line of sight, as well as a sponge-tipped lens cleaner that can wipe away the fog obscuring a camera lens without having to remove it from the site. Insufflators that heat and humidify the CO2 in the pneumoperitoneum, trocars that wipe the lenses of cameras passing through them, and laparoscope sheaths designed to channel insufflator air over the camera tip can also combat lens fogging in order to maintain visualization without interrupting a case.
Accuracy is everything
Do the technologies and techniques that have improved laparoscopic visualization over the past decade have a measurable impact? If your surgeons see better, can they operate more efficiently? Do their patients enjoy better outcomes? The short answer: maybe.
Dr. Baxt notes that no outcomes study and no national database of cases has tracked the results of the laparoscopic abdominal cases that have used HD, 3D, miniaturized cameras or other cutting-edge technologies against cases done with standard equipment. Longterm data requires long-term effort, he says, and everyone's got other jobs to do.
Adds Dr. Gorjala, "Between open and laparoscopic surgery, lap
