A
review of the use of computer-assisted video
endoscopy has drawn the conclusion that computers
can be useful in almost any type of endoscopic
procedure.
Researchers found that computer assistance allowed
greater understanding paranasal sinus structure
without increasing operation time in endosnasal
surgery.
The use of computers could be valuable in
revision surgery when normal anatomic landmarks were
missing.
Investigators from ‘Clinique ORL du CHU de
Grenoble’, in Grenoble, France, used computer
assisted video endoscopic surgery to treat benign
diseases the paranasal sinuses in 20 patients.
They assessed the accuracy and reproducibility of
the computer-assisted system by identifying ten
anatomical landmarks on each side of the paranasal
sinuses using the direct live video-endoscopy image
and comparing these images with axial, coronal and
sagittal views obtained with the Optical Digitising
System (Flashpoint 5000).
The localisation system used by the investigators
detects the position of two rigid bodies, one
attached to the patient’s head to track motion and
the second attached to the operating instrument to
track the location of the instrument tip.
A markerless, skin surface registration method was
employed to avoid the need for a second computed
tomography (CT) scan process fiducial markers. Data
from the patient’s usual CT scan is registered.
The computer-assisted system allowed a registration
and calibration accuracy less than 1.5mm in 89.2 per
cent of cases.
Movements of the patient’s head were monitored
reliably using the markerless skin surface points
method.
There was no significant increase in the length of
the operation and the investigation team concluded:
“Computer assistance can be used in almost any
type of endoscopic procedure.”
New
equipment
New equipment, enabling medical practitioners to
obtain a better view of what the endoscopy cameras
‘capture’ is being developed all the time.
One example is the SONY DMP-1000 Video Capture
Device and Printer - which does not need a computer
to get results.
Images can be used with a computer but can also be
printed out.
The DMP-1000 is a small format, small footprint
Mavica colour printer intended for use with a wide
variety of officebased professional printing
applications.
Colour images can be captured, stored and printed
directly from a camera or from almost any video
source.
Images previously recorded on a floppy disk with the
DMP-1000 can be accessed at any time for printing
and the device also allows the quick and easy
viewing and printing of images captured with a Sony
Digital Mavica camera. Its specifications include:
- No computer needed - it can print images directly
from a video source or 3.5 inch floppy disk
- Captures and stores video images on to a removable
3.5 inch floppy disk
- High resolution, photo-quality prints
- Remote capture (foot switch) capability
- Instant ‘back to live’ functionality
- Video output allows display of images on a
standard TV monitor
- Reverse and duplicate image capability
Health professionals who use endoscopes will, no
doubt, also be interested in an innovative package
which has been designed to convert fibre optic
endoscopes on to video.
The Olympus OTV-S2 Colour Video Camera Package
includes an OTV S2 Olympus camera, 13 inch new
Panasonic monitor, W42AE procedure cart, scope pole
mount and rack, WA Series eyepiece adaptor and rigid
endocoupler.
Further information on these pieces of equipment,
including price details, plus many other exciting
new endoscopy products currently available, or in
the pipeline, can be found on the web at: www.endoscopy.com/image_capture.htm
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 The
new OR1 from Storz in Tuttlingen, Germany,
gives medical experts the power to seamlessly
integrate and control virtually every
technology, alls in a single, optimised system
that is custom designed to match the
individual requirements of the environment it
is used in.
This is a conceptual drawing of a Capsule
Endoscope which Olympus is aiming to realise
asa dream endoscope of the future.
 If
a patient can easily swallow this endoscope
without sedation, it can be widely used for
diagnosis in the esophagus, stomach and colon.
It will have various functions that are
required for endoscopes, such as an image
capturing function, image telemetry function,
therapeutic device, positioning function and
propulsion system.
An ultrasmall CCD, miniature light source,
micro manipulator, micro sensor and signal
transmission are required. These functions and
devices will be realised by micromachining
technologies that the company is pursuing. |
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One-stop
clinic reduces endoscopy waiting times
A one-stop colorectal clinic in the north of
the United Kingdom has resulted in a
significant reduction of the number of
patients who are waiting for lower
gastrointestinal (GI) endoscopy, a study has
revealed
Dr L.S. Jones and his colleagues at the
Blackburn Royal Infirmary, Blackburn,
Lancashire, have been exploring how much a
one-stop clinic for colorectal patients can
reduce waiting times for lower GI endoscopy.
The study involved 197 patients who needed
evaluating for a range of colorectal
complaints such as rectal bleeding, altered
bowel habits and anorectal symptoms.
The clinic was held one day a week for six
months, during which patients were examined by
a consultant or specialist registrar. After a
history was obtained the clinical examination
was carried out in consulting rooms equipped
with facilities for rigid sigmoidoscopy,
proctoscopy and rubber band ligation. Flexible
sigmoidoscopy was also performed, but only
when it was deemed appropriate, rather than as
a strict policy. When this procedure was
thought to be necessary, consent from the
patient was gained and a phosphate enema was
used. No sedation was given.
At the end of their visit, patients were asked
if they would complete a questionnaire.
In a subsequent article in the Journal of the
Royal College of Surgeons of Edinburgh, Dr
Jones’ group observed:
“Colorectal services have traditionally been
arranged for the convenience of a hospital and
its staff rather than for patients.
Consultations and procedures are carried out
in different places and at different times.
This model is not ideal, particularly for
minor interventions and diagnostic procedures.”
During the study, 134 patients underwent
proctoscopy, 72 had a sigmoidoscopy and 85 a
flexible signmoidoscopy.
Subsequently, 24 patients had a barium enema
and three were put on a waiting list for a
colonoscopy. The main diagnosis was
haemorrhoids, which were diagnosed in 104
patients.
When the one-stop clinic opened, 119 patients
were on a waiting list for lower GI endoscopy.
At the end of the six month study the number
had dropped to 63. Two months later the number
had increased to 108.
The results of the questionnaire completed by
patients showed that most of them were
satisfied enough with the clinic being in the
evening. Only 13 per cent (26 patients)
reported that they would have actively
preferred a daytime clinic and most of these
were women with young children.
Dr Jones concluded that flexible sigmoidoscopy
without full bowel preparation and without
sedation was clinically feasible. |
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