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


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.


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.


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!).


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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