Nice or necessary?
Image enhancement technology clearly offers advantages to surgeons
performing minimally invasive procedures. But are those advantages
essential to the safety of surgery and the success of its outcomes?
After all, laparoscopic techniques flourished before the development
of these real-time visualization improvements.
"It is nice, yes, but you can do procedures without it," says
Sharona Ross, MD, director of minimally invasive surgery and surgi-
cal endoscopy at the Southeastern Center for Digestive Disorders at
Florida Hospital Tampa. She admits that it makes training easier, as
well as cases that involve advanced illness or inflammation. In gen-
eral, though, "it's not that hard to cut. If you follow standard steps
and techniques, you're not likely to cause injury."
"We're far from it being standard. We're not there yet, but the scope
of applications is growing rapidly," says Dr. Shah. "Frankly, they're
still relatively young technologies, and the clinical data is lagging
behind the technical data. Just because the imaging looks different
and looks better, does it bring value? These are meaningful metrics
we're trying to move."
For example, while surgeons resecting the colon believe that a bet-
ter blood supply — and as a result, contrast imaging of the colon —
leads to a lower risk of leaks, there isn't enough rigorous data to con-
clusively prove the point, he says.
As with high-definition cameras and displays, image enhancement's
clinical benefits might be unverified, but its practical benefits are
M A Y 2 0 1 6 • O U T PA T I E N TS U R G E R Y. N E T • 8 3
"We're developing tools that allow us
to see past the visible spectrum."
— Paresh Shah, MD
