Good experience with modern 4K camera technology

In med­i­cine, suc­cess­es and advances are close­ly linked to tech­ni­cal inno­va­tions. This is par­tic­u­lar­ly true for sur­gi­cal dis­ci­plines, where min­i­mal­ly inva­sive surgery, so-called key­hole surgery, has now become estab­lished. For sev­er­al decades, Siloah St. Trud­pert Klinikum and Richard Wolf, a med­ical tech­nol­o­gy com­pa­ny spe­cial­iz­ing in endoscopy sys­tems, have been work­ing togeth­er to advance optimizations.

“We expe­ri­ence first-hand how our instru­ments sup­port us in our dai­ly oper­at­ing rou­tine. In direct exchange, the sur­geons let us know where they see poten­tial for opti­miza­tion and what works very well. This is valu­able feed­back for us, which comes direct­ly from the oper­at­ing room and is incor­po­rat­ed into fur­ther devel­op­ment. For exam­ple, the devel­op­ment of the new ERAGON­stitch gen­er­a­tion of nee­dle hold­ers, from the first hand sam­ple to the final prod­uct, was accom­pa­nied by PD Dr. Schulz and his entire sur­gi­cal team.”

- Jür­gen Stein­beck, Man­ag­ing Director

The long-stand­ing, good coop­er­a­tion is also an impor­tant fac­tor for the doc­tors in their work. Sales rep­re­sen­ta­tive Matthias Fröh­lich from Richard Wolf is a fre­quent and wel­come guest at the hos­pi­tal. “Tech­ni­cal improve­ments not only make the sur­geons’ work eas­i­er and can improve it, they ulti­mate­ly ben­e­fit all patients. Every opti­miza­tion also increas­es patient safe­ty,” Matthias Fröh­lich summarizes.

A sim­ple but con­crete exam­ple: the qual­i­ty of the dis­play on the OR mon­i­tor. The clear­er the sur­gi­cal area is trans­mit­ted on the screen, the bet­ter even small details can be rec­og­nized by the sur­gi­cal team and the safer the pro­ce­dure can be for the patient. Since the first endo­scop­ic 4K tow­er with the lat­est tech­nol­o­gy and 4K res­o­lu­tion was installed at Siloah St. Trud­pert Klinikum back at the end of 2017, the sur­geons have had con­sis­tent­ly pos­i­tive expe­ri­ences. Every day, for exam­ple, the team at the Clin­ic for Gen­er­al, Vis­cer­al and Min­i­mal­ly Inva­sive Surgery uses the 4K sur­gi­cal tow­ers to per­form not only rou­tine oper­a­tions such as gall blad­der removals and her­nia oper­a­tions, but also com­plex pro­ce­dures on the stom­ach, pan­creas and lungs.

4K: This means four times the res­o­lu­tion of Full HD. The abbre­vi­a­tion 4K stands for 4,000 and refers to the approx­i­mate num­ber of hor­i­zon­tal pixels/images. The result is clear, razor-sharp images at max­i­mum bright­ness, above-aver­age con­trasts and an expand­ed col­or spec­trum. This dis­play enables a bet­ter spa­tial depth effect and relaxed view­ing for the view­er. “The small­est dif­fer­ences and details are made vis­i­ble — this makes our sur­geons’ work immense­ly eas­i­er,” PD Dr. Tim Schulz, Chief Physi­cian of the Clin­ic for Gen­er­al, Vis­cer­al, Tho­racic and Min­i­mal­ly Inva­sive Surgery, is enthu­si­as­tic about the high image quality.

“Espe­cial­ly for com­plex oper­a­tions on the intes­tine, liv­er, lungs or stom­ach, this tech­nol­o­gy is the new stan­dard and offers opti­mal sur­gi­cal con­di­tions.” In the con­text of bariatric surgery (surgery to treat mor­bid obe­si­ty), for exam­ple, the struc­tures are nev­er­the­less excel­lent­ly visu­al­ized by the mod­ern imag­ing despite being restrict­ed by obe­si­ty. These pos­i­tive expe­ri­ences with the endo­scop­ic 4K tow­er from the Richard Wolf com­pa­ny in Knit­tlin­gen have con­vinced the chief physi­cian and his sur­gi­cal team to such an extent that 4K tech­nol­o­gy is stan­dard in the oper­at­ing rooms at Siloah St. Trud­pert Klinikum.

Simply see more

From biop­sy for­ceps to ure­thero­scopes: gyne­co­log­i­cal, uro­log­i­cal and ortho­pe­dic surgery also rely on Richard Wolf instru­ments. Cur­rent­ly, the team of head physi­cian PD Dr. Schulz is increas­ing­ly per­form­ing endo­scop­ic pro­ce­dures using ICG (indo­cya­nine green)-supported flu­o­res­cence imag­ing in real time — also opti­mized to 4K. This uses green light for detailed image infor­ma­tion and improved spa­tial depth. “In this process, the intra­venous admin­is­tra­tion of a spe­cif­ic sub­stance (ICG) and a spe­cial image infor­ma­tion pro­cess­ing method pro­vide tis­sues such as tumors with detailed and high-con­trast images, mak­ing it eas­i­er to dis­tin­guish them from healthy tis­sue,” explains PD Dr. Schulz.

Fur­ther­more, ICG flu­o­res­cence can be used to visu­al­ize and repro­duce the blood flow to struc­tures such as the colon dur­ing col­orec­tal surgery. This can reduce the risk of seri­ous com­pli­ca­tions. “The pos­si­bil­i­ty of high­light­ing the blood flow and the anato­my even more clear­ly in this way and dis­play­ing them in a focused man­ner is an addi­tion­al plus point for sur­gi­cal work,” Matthias Fröh­lich points out. Dr. Ingo Thal­mann, head of the gyne­co­log­i­cal clin­ic, and Prof. Dr. Stephan Kruck, head of urol­o­gy, con­firm the advan­tages for their sur­gi­cal disciplines.

In addi­tion to flu­o­res­cence-assist­ed surgery, the top­ic of “more vision” is also a major theme in the coop­er­a­tion between the hos­pi­tal and Richard Wolf GmbH in the Depart­ment of Urol­o­gy. The “Sys­tem blue” used in the area of blad­der can­cer screen­ing enables so-called “blue light diag­nos­tics”, in which the use of flu­o­res­cent blue light sig­nif­i­cant­ly improves the detec­tion of cer­tain blad­der tumors — com­pared to pure diag­nos­tics under white light. The pro­ce­dure is called pho­to­dy­nam­ic diag­nos­tics (PDD) and has been prac­ticed very suc­cess­ful­ly at the hos­pi­tal for many years. “Light cells in the tumor cells are acti­vat­ed and appear flu­o­res­cent, mak­ing them eas­i­er for the sur­geon to per­ceive and con­trol dur­ing the pro­ce­dure,” says the chief urologist.

Future-oriented partnership

Impuls­es for new, future devel­op­ments and joint projects do not only come from the oper­at­ing room; events can also pro­vide the impe­tus, as the exam­ple of the Coro­na pan­dem­ic shows. Togeth­er with Dr. Thushi­ra Weer­awar­na, Chief Physi­cian of the Clin­ic for Pneu­mol­o­gy, Res­pi­ra­to­ry and Sleep Med­i­cine, sev­er­al dig­i­tal work­shops have tak­en place since last year. These have cov­ered bron­choscopy with Covid-19 and air­way man­age­ment with the lat­est gen­er­a­tion of flex­i­ble sen­sor bron­cho­scopes from Richard Wolf. The expe­ri­ence of two pan­dem­ic years by Dr. Weer­awar­na and his team, along with feed­back from physi­cian col­leagues, gives a very good over­all pic­ture. “The goal is to expand such events, dig­i­tal as well as live, in the future and to con­duct bron­choscopy work­shops world­wide togeth­er with Dr. Weer­awar­na,” says Jür­gen Steinbeck.