Asian Hospital launches fully integrated operating room

(The Philippine Star) Updated March 11, 2010 12:00 AM Comments (0)

Asian Hospitals Stryker Endoscopy Suite is equipped with state-of-the-art voice-activated devices and touch-screen command centers. | Zoom

MANILA, Philippines - Asian Hospital and Medical Center is again at the forefront of delivering worldclass patient care as it launches the Philippines first and only minimally invasive surgery integrated operating room suite. The Stryker Endoscopy Suite is an advanced surgical operating room where all laparoscopic and endoscopic surgical procedures today can be best performed. Dr. Orlando Diomampo, head of the Department of Surgery of Asian Hospital, said this state-of-the-art facility is another breakthrough in modern-day surgery from Asian Hospital. Minimally invasive surgery is one of the pillars in Asian Hospital. Through the years, weve worked very hard to develop and deliver this surgical expertise and to provide the best facilities and the latest technologies that would benefit our patients, Diomampo said. The Stryker Endoscopy Suite reflects our commitment to giving only the most up-to-date technologies that complement our surgical expertise and procedures. This mirrors our vision of making Asian Hospital the Center of Excellence in minimally invasive surgery, he added. The Stryker Endoscopy Suite is a fully integrated operating room (OR) with the unique capabilities of interconnectivity to other units in the hospital such as pathology, radiology, doctors clinics, conference facilities, patient rooms, and even in other hospitals in the Philippines and abroad. It is also equipped with state-of-the-art voice-activated devices and touch-screen command centers, which means the entire system is activated with a few verbal commands from the surgeon or the nurse to control all surgical equipment, OR lights, dictate notes and document findings using still pictures and/or motion video. The suite also consists of the latest in technology of large-screen, high-definition LCD monitors, highflow insufflators, and environment-friendly LED lights, all mounted on ceiling pendants and booms. With its cutting-edge features, the Stryker Endoscopy Suite boasts of a number of benefits both for doctors and patients. Dr. Miguel Mendoza, minimally invasive surgery section head, said, With the interconnectivity feature, surgeons can conduct consultations during a surgical procedure and get them the information they need all at once. The LCD monitors present a vivid picture and better resolution, thus appraisal of the surgery becomes better. The LED lights do not emit heat like the usual OR lights, so the chance of burning the tissues when the surgeon puts the light inside the body cavity is negligible. The insufflators, meanwhile, provide the highest flow rate at 45 liters per minute.

Mendoza added: Because of the wireless technology offered by the voice and touch-screen features and with the equipment all mounted on the ceiling, theres no requirement for manual maneuvering in the room and no clutter of wires on the floor. This gives the surgeon and nursing staff greater mobility during the procedure, allowing them to focus full-time on the patient care, thus increasing the overall efficiency of the entire surgical team. The efficiency generated cuts operating time and allows faster turnover of cases, enabling the surgical team to do more surgery in a day or attend to other matters right away. or the patients, the combination of surgical expertise and a highly specialized operating room all translate to advantages that ultimately deliver excellent quality in surgical patient care shorter hospital stay, significantly less painful recuperation period, faster recovery time, lower infection rate, earlier return to work and usual activities, and less visible scars. With the advent of machines and new technologies, its the goal of Asian Hospital to inspire, stimulate and train other surgeons to do minimally invasive surgery to be at par with all hospitals in the international community, Diomampo said. To know more about the Stryker Endoscopy Suite and the minimally invasive surgical procedures offered by Asian Hospital, call 771-9000 to 9002, e-mailinfo@asianhospital.com or Visit www.asianhospital.com.

Bringing 3D to the operating room

One of VPL's disparity (proportional to depth) estimation methods. Left image: original view (one from the stereo pair). Middle image: initial disparity estimates. Right image: Refined disparity using space-time minimization. (PhysOrg.com) -- For all of their high-tech advantages, laparoscopic surgical systems are only capable of providing a two-dimensional visualization -- or in other words, no depth perception.
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This means that often surgeons cant pinpoint the exact location of an organ until they brush up against it with their tools, explains Ramsin Khoshabeh, a Ph.D. candidate in Electrical and Computer Engineering at the University of California, San Diego. I hate to put it this way, but some surgical procedures are still done by brute force. Khoshabe and his colleagues are part of the Video Processing Laboratory (VPL), which is run by electrical engineering professor Truong Nguyen from the UC San Diego Jacobs School of Engineering. The researchers, who are also part of the UC San Diego division of the California Institute for Telecommunications and Information Technology (Calit2), are working to bring three-dimensional video feeds into the operating room by leveraging the use of autostereoscopic displays. Their hope is that one day surgeons will not only be able to perform minimally invasive surgeries in 3D, they will be able to do so without having to wear potentially cumbersome 3D glasses. Surgeons are often slow to adapt to new technologies, says Khoshabeh. They worry that a new technology will be dangerous, that it will interfere with the procedure. They say, Ive been doing this the same way for 40 years; why change things? To accommodate for all these types of mentalities, we are pitching 3D laparoscopic surgery as a supplement. Its a way for surgeons to enhance their abilities, and its also a way for interns and everyone else in the room to learn from what they are doing by watching the video feed. Professor Truong Nguyen, from the Department of Electrical and Computer Engineering (ECE), is an expert in digital signal processing. Other collaborators include worldrenowned UCSD surgeons Dr. Mark Talamini (chairman of the UCSD Department of Surgery) and Dr. Santiago Horgan (director of Minimally Invasive Surgery), as well as Dr. Horgans researcher, Dr. Noam Belkind. The work being done at the VPL with collaboration from visiting scholars from all around the world is at the forefront of research in 3D processing.
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Researchers on the fourth and fifth floor lab space at Calit2s Atkinson Hall focus their efforts on all aspects of 2D and 3D image and video processing, including disparity

estimation, 3D perceptual measures, image stabilization, frame-rate up-conversion, saliency detection, motion estimation and compensation, coding, and object detection, extraction and tracking. Khoshabeh and a few of his colleagues including Electrical and Computer Engineering graduate students Can Bal, Lam Tran, Stanley Chan, Ankit Jain, KyoungRok Lee and Jason Juang have concentrated their efforts on developing algorithms that address three of the greatest challenges in 3D research: virtual view synthesis, disparity estimation and the development of proper 3D evaluation metrics. Since 3D stereo is actually comprised of two images (one for the left-eye view and one for the right-eye view), both images must be properly aligned in order for the viewer to accurately perceive the 3D effect. For many 3D applications, virtual views need to be synthesized from the existing two images to allow viewers to see a 3D scene from another perspective. When these virtual views are generated, however, previously hidden regions in the scene (perhaps occluded by an object in the foreground) become uncovered, which means that holes appear in the virtual images. Khoshabeh and his colleagues in the VPL are looking at ways to fill in holes by extrapolating neighboring information from, say, the left-eye view to fill a hole in the right-eye view, or to improve the method for matching up points in one view to points in another view (also known as disparity estimation). Notes Khoshabeh: For humans, this is easy, but for computers this is a non-trivial task. And as you can imagine, this is very important in terms of surgery. If you have something that looks strange in a 3D laparoscopic feed, a surgeon might think its a tumor, but really, its just a poorly synthesized hole. As the technology evolves, not only will the holes go away, surgeons will be able to see a real live 3D effect, where they can look behind something. But right now, thats the tricky part capturing whats behind and providing surgeons with accurate visualization. Although it can create challenges in terms of creating a true 3D effect, Bal notes that extrapolating from one view to capture another is an effective technique for maximizing transmission efficiency and thats important when viewing and potentially sharing such large file sizes. Having two views means youre dealing with twice the amount of data, he explains. Its really dumb to send all that information twice when theres so much overlap, so there are some intelligent things we can do to reduce the file size and bit rate. Parallels exist with current 2D video technologies, such as H.264 encoding, which uses motion estimation to correlate sequential video frames. Something similar can be done with 3D videos, except that, by contrast, they have angular correlation (between left and right views) and temporal correlation (between, say, frame t and frame t+1). Khoshabeh says that fusing these two cues will be crucial to achieving high 3D coding efficiency in the compression and transmission of high-resolution 3D data. The researchers are hoping that one day their algorithms will be standardized by the Moving Picture Experts Group (MPEG), a working group of experts that was formed to set standards for audio and video compression and transmission. Trans algorithm for virtual view synthesis is already the top performer in the field. But, Khoshabeh says, theres still a lot of room for innovation. The reason I got involved with this research is because I wanted to take general engineering practices and apply them to medicine, he adds, noting that he intends to apply to UCSDs Medical Scientist Training program. Even though weve had so many breakthroughs, surgeons are still sewing people up just like they have for hundreds of years.

The problem right now is that the engineers dont know what the doctors need, and the doctors dont know what the engineers are capable of doing. I want to bridge that gap. This work in 3D laparoscopy is only the beginning. Provided by University of California - San Diego (news : web)