ENDOSCOPE GUIDE
EN
D
Redefining endoscope
quality in HD world
by Gregg Agoston, B.S., M.B.A., Karl Storz
W
ith the increasing availability ensuring the quality of endoscopes that ensure that no damage occurs to this lens
of high-definition television are delivered to the OR. system, and when it does, that it is no-
(HDTV) in homes across the ticed quickly. With HD video systems’
nation, surgeons were given a spectacu- Guiding light amazing resolution, any damage to the
lar new viewing experience in their Generally, when we think of an endoscope, lens system will be noticeable when the
own living rooms. HD technology has we first consider the image quality. Before scope is in use. It is the responsibility of
now become the new standard in most an image can be generated, however, light CSPD personnel to perform final inspec-
teaching hospitals and many commu- must be emitted from the endoscope then tions prior to sterilization. This includes
nity hospitals, owing to the superior recaptured by the endoscope to transmit carefully looking through the scope at a
overall image quality and wider view- the image. Adequate light output is criti- close, well-illuminated object to check the
ing field. Changing from standard-defi- cal for a HD image quality. Light is trans- image for any abnormalities.
nition (SD) video with a 4-by-3 aspect mitted through the endoscope by fiber op-
ratio and 780-by-1460 resolution to 16- tics, and these flexible hair-size glass fibers Tips for proper handling
by-9 1080p video significantly improves are packed inside the endoscope between The Prep and Pack staff should first clean
the quality of clinical images. This gives the inner shaft and outer tube. By shining a all windows at both the distal and proxi-
surgeons a greater ability to visualize low-powered light through these fibers, mal ends with alcohol. Extra attention
anatomical details that were not pos- we can assess their condition by looking should be paid to the distal end because it
sible with SD video systems. for black, grey or brown dots. is this end that is exposed to blood and
The use of a magnifier is helpful when body fluids. Once cleaned, the best way
Not everything has changed performing this inspection to visualize to inspect the endoscope is to visualize
HD technology now offers video images each fiber. A black appearance indicates typed letters on a white background from
with dramatically superior clarity, reso- that the fiber is not transmitting any light; a distance of 5 centimeters to 8 centime-
lution, and detail. But, at the same time, any fibers appearing grey or brown are ters, looking at the center of the image
endoscopes have remained generally the damaged but are transmitting a limited and the entire perimeter of the image.
same, with the rod-lens rigid endoscope amount of light. The smaller the diameter Looking across the room through the en-
remaining the predominant type used in of the endoscope, the smaller the number doscope is an inferior method of evaluat-
the OR. What has changed is that the en- of fiber optics it contains, and the fewer ing the endoscope and will often allow
doscope is now often considered the de- that can be damaged before image degra- damage to be missed due to the distance,
vice that limits the video quality of HD dation occurs. Generally, we recommend color shapes, and patterns that mask the
systems. Essentially, the amount of vi- replacement when 20 percent or more of damage. Inspection errors can result in
sual information, or data, being transmit- the light fibers are damaged, and the en- major difficulties in the OR.
ted through the imaging chain linking doscope has been inspected by qualified
the object being viewed and the surgeon staff and deemed to be unacceptable.
Have a plan of action
is limited by the component with the low-
Ensuring the best quality video for your
est resolution. With 1080p HD camera Transmitting the HD image
surgeons and staff begins with having
resolution now approaching the optical The second critical function of the endo-
all members of the perioperative team
diffraction limit of today’s endoscopes, scope is to transmit images. Image trans-
work together to prevent damage to the
the quality of the endoscope itself be- mission is accomplished by a system of
endoscopes and other video equipment,
comes the limiting factor. lenses in a rigid rod-lens endoscope. Be-
then making sure that optimum prac-
In the HD environment, anything that ginning with the objective lens and then
tices are followed during every other
has a negative impact on the quality or followed by a series of rod lenses and
phase of the endoscope’s daily cycle.
performance of the endoscope’s critical spacers to the ocular lens, each of these
Your manufacturer’s representatives
functions or performance will diminish lenses must transmit the image. Spacers
should help you to design a plan of ac-
the image quality. And because HD reso- are placed between the lenses to reduce
tion to ensure this. By implementing
lution is significantly greater than SD reflection, refraction, and absorption of
and monitoring a plan of action to en-
video, any flaws in the endoscope are the image as it is transmitted through the
sure the highest possible performance
likely to be magnified on the resulting endoscope. Compared to the fiber optic
of your endoscopes, you can ensure that
HD images. This places greater impor- system in a rigid endoscope, the rod-lens
you’re getting the maximum benefit
tance on maintaining the endoscope’s system sustains damage more frequently.
from owning an HD video system. The
performance characteristics, and under- Damage is commonly caused by trauma
endoscopic image chain is only as good
scores the need to strongly emphasize sustained during use or from lapses in
as its weakest link. HPN
rigorous inspection and damage preven- good care and handling practices.
tion methods. This also increases pres- To ensure the highest quality HD im-
Gregg Agoston, B.S., M.B.A. is associate di-
sure on the personnel responsible for age in the OR, great care must be taken to
rector, Karl Storz Services.
SCOPES continues on page 44
42 November 2009 • HEALTHCARE PURCHASING NEWS www.hpnonline.com
0911-Scope Guide-shorrt.pmd 42 10/13/2009, 4:38 PM
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