“Digital Operating Room” is used to suggest better surgery through a better surgical environment. In a recent article we discussed this in detail .
The basic “Digital operating room” integrates 1 operating room. This generally indicates that in 1 operating room endoscopic images can be shown to the surgeon on any screen in that room (routing and switching). In addition images from previous exams such as X-rays, or the patient file can be displayed for review by the surgeon. For the surgeon it is useful if more information is easily available. In addition most digital operating rooms offer the possibility of recording operating images, and of broadcasting surgery. The latter however, generally need dedicated assistance for conferencing.
The underlying technology is similar to a television studio where a technician chooses which image of the several camera’s will be shown to the public. Since a (video) cable needs to connect every source and every screen with the broadband switch, this results in a bunch of cables and a rather static configuration with little intelligence. Indeed a new device or screen will need a new cable set of cables.

- The advanced digital operating room integrates the hospital . Similar to the intranet of most hospitals, which connects every computer, printer etc with the computer room, the advanced digital operating room will use an internet platform to connect all devices from 1 or all operating rooms using the IT network of the hospital.
The advantages and the differences from the older solution are obvious. Since many signals can be transported over 1 internet cable, this system needs only 1 cable instead of a bunch of cables from everywhere to everywhere (6 sources and 6 screens need twice a bunch of 6 video cables). The new digital operating room is no longer limited to 6 image sources, and thus easily connect any screen to any image source from another room. This obviously is important for teaching and supervision since any intervention can be observed from any other room (a senior surgeon keeping an eye on a junior), any computer in the hospital, or a composite image over-viewing a series of interventions, or a series of anesthesia screens. This facilitates teaching in or outside the hospital, which is controlled by the surgeon without needing any additional dedicated personnel.
Key is the digitalization of the images to an internet format and distribution of the images without delay, a problem that has recently be solved.
This system is plug and play and intelligent. Any new device can be connected and will be recognized.
This system is super safe. Critical images such as those used for surgery are routed directly from the source to the screen, in case the computer network would fail
This system permits multiple video registrations form 1 room such as a combined hysteroscopic and laparoscopic intervention.

In conclusion a “Digital Operation Room” benefits surgery by the integration of information of 1 operating room. The new concept of “digital operating room” over IP can integrate all operating rooms of an hospital. Because of its versatility, it will boost supervision and training. Finally emerging dedicated apps are improving the vision of the surgeon to distinguish specific tissues.

Philippe R. Koninckx

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