Understanding and optimizing laparoscopic videosystems

As tactile feedback and degree of freedom for instrument movement are restricted in laparoscopic surgery, the video image plays the most crucial role in giving the surgeon information about the performance of the operation. The development of small, reliable, high-resolution imaging systems is essential for the surgeon's acquisition detailed information about the tissues being manipulated. Image quality depends on each component of the laparoscopic imaging unit. In this context, it is crucial for the surgeon to have an understanding of how the video signal is formed, transmitted, and displayed. Moreover, the surgeon also needs to have an idea about the basic principles and specifications of the surgical video systems (i.e. charge-coupled device (CCD) camera, monitors, and digitizers). This knowledge is essential for choosing pieces of equipment and knowing how to assemble them into a functional operating suite. The aim of this review is to provide the surgeon with the basics of video signaling, and to familiarize him or her with the technical principles of the surgical video systems. An insight into the future of laparoscopic video systems also is made, and practical tips for improving image quality and troubleshooting are given throughout the article.