用于内窥镜检查和自然腔道内镜手术的实时视频操纵器（附视频）
Live video manipulator for endoscopy and natural orifice transluminal endoscopic surgery (with videos).
作者信息
Tang Shou-Jiang, Bergs Richard, Jazrawi Saad F, Olukoga Christopher O, Caddedu Jeffrey, Fernandez Raul, Scott Daniel J
机构信息
Division of Digestive and Liver Diseases, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
出版信息
Gastrointest Endosc. 2008 Sep;68(3):559-64. doi: 10.1016/j.gie.2008.04.018. Epub 2008 Jul 16.
BACKGROUND
During fluoroscopy, radiologists and gastroenterologists are able to manipulate live fluoroscopic video for better orientation and visualization. During endoscopy and natural orifice transluminal endoscopic surgery (NOTES), this function is not currently available. Particularly during NOTES, the endoscopic image is sometimes inverted, and off-axis operation is required.
OBJECTIVE
Our purpose was to develop and test a prototype live video manipulator (LVM) for endoscopy, laparoscopy, and NOTES.
DESIGN
Prospective ex vivo and in vivo feasibility study.
INTERVENTIONS
We developed a prototype LVM software for video image manipulation that can be easily installed on any computer. The video input is streamed into the computer and can be displayed on a standard monitor. LVM was tested ex vivo in the following functions: (1) instant live video rotation, (2) vertical or horizontal video inversion, (3) mirror imaging, and (4) digital zooming. These functions were also tested during upper and lower GI endoscopy, ERCP, diagnostic laparoscopy, and various transvaginal NOTES procedures (cholecystectomy, gastroenterostomy, and sleeve gastrectomy) in porcine models.
MAIN OUTCOME MEASUREMENTS
Image quality observation between unmanipulated and manipulated live videos.
RESULTS
LVM reliably and easily performed live video manipulation during these tests. Besides standard definition video signals, LVM is fully compatible with high-definition video endoscopy. Three observers reported that the subjective image quality was the same in specified areas between manipulated and unmanipulated live videos.
LIMITATIONS
Observation and feasibility study.
CONCLUSIONS
LVM reliably and conveniently performed live video manipulations. LVM requires minimal equipment, capital investment, and maintenance, and is easy to set up. LVM can be a useful tool in many medical imaging studies, including endoscopy, laparoscopy, and NOTES, either as a built-in technology or as an as-needed add-on feature.
背景
在荧光透视检查期间，放射科医生和胃肠病学家能够操控实时荧光透视视频以获得更好的定位和可视化效果。在内镜检查以及自然腔道内镜手术（NOTES）期间，目前尚无此功能。特别是在NOTES手术中，内镜图像有时会倒置，需要进行非轴向操作。
目的
我们的目的是开发并测试一种用于内镜检查、腹腔镜检查和NOTES手术的实时视频操纵器（LVM）原型。
设计
前瞻性体外和体内可行性研究。
干预措施
我们开发了一种用于视频图像操纵的LVM原型软件，该软件可轻松安装在任何计算机上。视频输入流进计算机，并可显示在标准监视器上。LVM在体外进行了以下功能测试：（1）即时实时视频旋转，（2）垂直或水平视频翻转，（3）镜像成像，以及（4）数字变焦。这些功能还在猪模型的上消化道和下消化道内镜检查、内镜逆行胰胆管造影（ERCP）、诊断性腹腔镜检查以及各种经阴道NOTES手术（胆囊切除术、胃肠造口术和袖状胃切除术）中进行了测试。
主要观察指标
未操纵和操纵后的实时视频之间的图像质量观察。
结果
在这些测试中，LVM可靠且轻松地完成了实时视频操纵。除了标准清晰度视频信号外，LVM还与高清视频内镜完全兼容。三名观察者报告称，在操纵和未操纵的实时视频的指定区域内，主观图像质量相同。
局限性
观察性和可行性研究。
结论
LVM可靠且方便地完成了实时视频操纵。LVM所需设备、资金投入和维护最少，且易于设置。LVM可以成为许多医学成像研究中的有用工具，包括内镜检查、腹腔镜检查和NOTES手术，既可以作为内置技术，也可以作为按需添加的功能。
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