World’s Highest Resolution HDTV Surgical Camera – Ever! – First Exclusive Evaluation

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hdksea 

I have previously posted about my research on the use of high definition TV (HDTV) for surgical endoscopy.  I am honored to have participated in the evaluation of the highest resolution surgical system ever created which I used to capture the footage showcased in the amazing upcoming National Geographic HD special “Inside The Living Body” which will be the first surgical procedure broadcast in HD.   

What’s also new is that this system allowed me to record footage that will be seen by the lay public in their living room that is higher resolution and quality than virtually any surgeon has ever seen in the OR!

In this post I want to review the system used and how it differs from other surgical systems.   This will also give me a chance to review many of the failings of HD systems in use in the OR today as well as provide surgeons with important caveats in choosing a system.  I’ll also provide you with some photos and stills from the system and further details of the National Geographic TV special.

For those interested in the history of HDTV surgery and the details of its development further details of my work are here from the New York Times and here from Science Daily and here from MIT Technology Review. 

Development of the World’s Highest Resolution Surgical Camera System Ever!  Ever since I helped develop HDTV surgery I have had a close relationship with both the manufacturers of surgical video systems and tools and those in the video business itself.  It took more than 5 years from that first procedure for each of the major surgical video companies to come around and embrace HDTV as the next innovation (even those there is a huge difference in quality and design) between the systems.   

You can imagine my delight when I was approached by Thomas Prescher (Director of Upstream Marketing) at Karl Storz Endoscopy America (KSEA) to evaluate and critique a unique new prototype HDTV surgical system with the highest resolution ever.  I have known Thomas for many years since he first came to the USA from Germany to lead the gyn marketing at Olympus Surgical (where we collaborated on research on head mounted displays, microendoscopy, among others).  At Karl Storz Thomas is helping to really push the envelope of technological innovation in endoscopy and is someone who shares much of my vision for the transformation of surgery in the future.  They have even launched a website on HD endoscopy.  Besides this HD project we collaborated on the development and testing of the autofluorescence based endocopy system that was awarded prizes at the AAGL, SLS, and ASRM meetings earlier this year.  

I was truly impressed when I tested the system and can say that it is the highest resolution images I have ever seen in endoscopy.  Those assisting me in the OR stood with their mouths open in amazement at the beauty of the images and started calling for other surgeons to see what I was doing.  We were operating for the first time with a chip that was imaging at 1920 x 1080p (beyond WUXGA for you computer geeks). 

One week later I received a call from the National Geographic Producers in London who got wind of my work and were requesting copies of some of the footage for use in their upcoming HDTV show on human body.  They were thrilled that I could provide them with HD footage that would be the first ever HDTV surgery ever broadcast in the world.  I jumped at the chance to share my passion for this amazing tool with the lay public and my patients fought for the chance to be the uterus seen around the world. For more than 5 years I have lectured and spoken on why HDTV surgery can help advance endoscopic surgery.

hdhead 

Details of the KSEA HDTV Surgical System - The Karl Storz Image1 HD Video System is unique in having a native chip resolution of 1920 x 1080p in the first ever (for surgery) 16:9 aspect ratio (Full HD).  This HD system employs a 3CCD camera with an acquisition resolution (at the chip) of 1920 x 1080.  This translates to approximately 2 megapixel video.  The image is progressively scanned outputting 60 full frames per second, versus the 60 half-frames or fields output by interlaced systems.  This provides full detail with twice the frequency and also minimizes motion artifacts caused by rapid movement- vital for smooth surgery.   

Advantages of The System:

  1. highest resolution ever for a medical endoscopic camera.  Allows the surgeon to see finer detail and clearer images.  It remains to be seen if this will allow the visualization of smaller disease implants but it seems likely.
  2. This high resolution is native from the chip not interpolated by the camera system or faked with post chip processing (much more on this in the follow up posts on will the true HD please stand up). 
  3. Progressive scanned image smooths the motion seen and reduces motion artifacts.
  4. First ever wide 16:9 aspect ratio.  Gives more lateral detail and information during surgery.  Just like the differences you see in wide aspect ratio TV’s vs standard.
  5. First ever ability to record images at full 1080 HD resolution for teaching and archiving.  More about this later but this is what we used for National Geographic.

HDMONITOR 

First Ever Surgical 16:9 Monitor:  It is displayed on a 16:9 ”WideView monitor” with the same native resolution (1920 x 1200) so that the full 1920 x 1080 image can be displayed without degradation.  The advantage of using this is that it will maximize the horizontal field of view of the surgeon. In general we operate in a horizontal plane with our instruments next to each other. A true wide aspect ratio monitor will allow a wider lateral field of view and give more space to operate under direct vision as well as allow the surgeon to see instruments entering his field of view earlier.  (Editorial Note: I can remember sitting in the courtyard at Patty O’Brien’s in New Orleans at 1 AM with Thomas drawing out this concept on a napkin – during the American Society for Reproductive Medicine Conference Last November- and being convinced of the potential benefits as we debated what technology could transform surgery in the next decade – but that’s another story- podcast on this topic here.  Not surprising that a late night social event turned into yet another medical technology brainstorming session past midnight for me!).

wideview

This is the HUGE field of view obtained with this first ever 16:9 system!- Shot from my OR

Images From the System: –

note these are screen grabs from the video - actual images are higher res with less motion artifacts

vascular(click for hi res image)

hdbowelclick for hi res bowel

tubehdclick for high resolution tubal photo

Read here on what we had to do to record the footage from the OR in HD and get it to National Geographic using a new HD recording system based on blu-ray

Come back to see follow up posts on what was created to allow true HD reacording of these images and how so much HD in the livining room and the OR is not really true HD or set up incorrectly negating its potential benefits. 

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94 thoughts on “World’s Highest Resolution HDTV Surgical Camera – Ever! – First Exclusive Evaluation”

  1. how can this be true HD when there is a traditional Hopkins rod/lens scope in front of the camera head? I don’t think anyone has developed a way to get 1080 lines of resolution out of a piece of glass. Furthermore, how can you measure resoltion from the rod/lens scope? It is my understanding that the only way to quantify resolution is from the CCD chip in the camera. The camera may be HD but there is now way that the scope is.

    Reply ↓

  2. Professional HD video cameras recording in 1080 have glass lenses so I am not sure why you think no one can get 1080 lines through glass. The only possible alternative to a glass lens scope is to use a distal imaging chip (“chip on a stick”) and there is no data that these image better than a rod lens scope. Interestingly, I tested many scope designs back in 2000 when we did the first HD endoscopy and as expected there is trmendous variability between those of different manufacturers.

    Certainly, the telescope with all its lenses (objective lens, rod lenses, ocular lens) contribute to the image quality on the monitor. In addition, the camera, the video cables and the monitor contribute as well. To get the highest HD quality, all components must be of the highest quality. including scope, iamging chip camera head, video cable (no Monster medical cables yet…) and monitor.

    For a surgeon, the image quality displayed by the monitor is what really counts. I will be posting a follow up on many of the ways systems differ in resolution despite looking similar on paper.

    Reply ↓

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  26. Wow, those images are truely amazing. Even with the motion artifacts those are amazing pictures…that must really help to have such clarity during surgery.

    One thing I noticed, you said 1080p HD is beyond WUXGA. That’s actually not true.
    1920×1080 = 1080p HDTV
    1920X1200 = WUXGA.

    I’m writing this on my laptop with a WUXGA screen, and when I watch HDTV movies, the screen gets letterboxed. But that’s just semantics. Regardless, The quality of the images you have shown on this site is amazing.

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  38. are you sure the 3ccd is progressive?
    the images, especially the 1st sample (peritoneal cavity?)
    seems to have interlacing artifacts

    Reply ↓

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  41. Pete-

    Yes the chip is progressive scan but unfortunately we had to convert to 1080i to capture the video for National Geographic for their HD broadcast. The still are just frame grabs from the video recorded and does have interlacing artifacts. The live stream was even better but we did not set up a hig res still capture that day. You can read more about what we did to cpture and convert the video at http://docinthemachine.com/2007/08/02/recordhd/

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  51. The KSI chip most likely does not have a native resolution of 1080p. Processing the image up to 1080p is the way. Only chips that have a native 1080p is in broadcast market. They de-interlace the video to make it p from i. 720p vs up-processed 1080p is virtually the same in a side by side comparrison.

    Reply ↓

  52. There is a huge diference between 720p & 1080p, even when the 720p is line doubled. You are using logrithms to interject lines that don’t exist in the original chip design to make it fill a 1080p chipsize.

    I sell these cameras, and the technology has come a long way, but there are still factors that need improvement, like having to have a 300W Xenon light source for the chip to have decent imaging for anything deeper than a few millimeters.

    I have spoken at length to the manufacturer who makes 700,000 of these each year, most likely for each distributer but packaged differently, and there are still limitations.

    It IS CERTAINLY an improvement over traditional analog systems, so don’t fire hatemail back at me, but you have to have 1080p to start with if you want 1080p resolution. Line doubling a 720p camera does not equal 1080p.

    Reply ↓

  53. firstly, The KS chip is not 1080P (no manufacturers is) nor is it 1920*1080 in size or resolution. The image is upscaled by the processor and enhanced electronically. Secondly the hole concept of using 1080 Hd resolution in 16:9 aspect ratio is against the way surgeons actually operate. All laparoscopes are round, to get a full screen image 16:9 you have to blow the 1080 inage up (with a lens or electronic zoom) or stretch it out optically. Either way the image is not showing 1080 lines, and has a distortion effect. Effectively round circles fit more snuggly inside a square that a rectangle, therefore you dont loose so much information off the periphery both side and top. Dont get caught up in their marketing hype. When you use a laparoscope the quality of the lens has a marked effect on the image, and slight chip, fog or moisture invasion deteriorated the image significantly and dont forget the light guide cable, most hospitals reuse these to death thereby significantly lowering the light quality and colour. The chip on the tip concept is actually very valid as there are less interfaces to distort and discredit the image. In the future one of these with a 1920*1080 lens would blow everyone away im sure.

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  58. Wow, those images are truely amazing. Even with the motion artifacts those are amazing pictures…that must really help to have such clarity during surgery.

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  60. Wow, those images are truely amazing. Even with the motion artifacts those are amazing pictures…that must really help to have such clarity during surgery..

    Reply ↓

  62. This translates to approximately 2 megapixel video. The image is progressively scanned outputting 60 full frames per second, versus the 60 half-frames or fields output by interlaced systems. This provides full detail with twice the frequency and also minimizes motion artifacts caused by rapid movement- vital for smooth surger

    Reply ↓

  81. hmm… Colayer too is cool web app, instead a good collaborative and contextual communicative ‘PLATFORM’.
    ….waiting to explore similarities between Wave and Colayer after wave release.

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  88. As the technology upgrade faster now a days.It’s good to hear also that we have a new technology being used for surgical operations which definitely an advantage to surgeons .Since it has a higher resolution they could now clearly see what they can only visually seen before in OR.

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