Sony: Operating Room Assistant
By Phil Scott

SONY Medical Systems unveils four new digital products destined for an operating room near you

This is a story that began not all that long ago. It was a Saturday afternoon in my apartment in Manhattan. Very slowly I developed a terrific headache—something like a migraine—that lasted through the night and all day Sunday. I woke up with it Monday and my wife-to-be urged me to see the doctor. So I phoned my primary care physician, who couldn’t schedule an appointment until
the following day. But although it seemed impossible, the headache kept getting worse. At 4 A.M. on Tuesday my fiancée called an ambulance, which took me to the emergency room at a nearby teaching hospital. Things begin to get foggy here, but my fiancée says that, according to the overhead monitor, my pulse dropped to below 20 beats per minute and I began checking out. In other words, I was dying. One intern asked her if I had any relatives in the area. I guess he wanted them around to say good-bye as I faded away.

But another intern scheduled an MRI, which showed a colloid cyst about one inch long and a half- inch in diameter in the middle of my brain, preventing the cerebral spinal fluid from draining down my spine. I was rapidly turning hydrocephalic, with the blocked fluid creating an incredible pressure inside my brain. The doctor that the intern consulted had little time to act—right there in the emergency room he drilled a hole in my head and, my fiancée says, as soon as the drill breached the interior of my skull a three-foot-long stream of fluid shot out with all the pressure of a garden hose. The doctor drilled two more holes, then placed shunts in each of the holes.

After I stabilized two days later I was loaded on agurney and taken to another room. I was told that the doctors had to remove the tumor. There was a chance that I’d be paralyzed. Hardly listening at all I took the release form, immediately scribbled my name on it, and they wheeled me into the operating room. It was packed with white gadgets. Some of them beeped. A few minutes later, someone clamped a mask on my mouth and nose and told me to breathe normally. I fell into a dreamless sleep.

THE CAMERA

Every day thousands of people enter hospital operating rooms in America and depend on the nurses and doctors and their tools. For instance, when I had my tonsils removedabut thirty years ago I woke with an extreme hangover from the anesthesia. But when I had knee surgery five years ago I awoke alert and cracking jokes. And though most of those white gadgets in the operating room during my brain surgery were state-of -the-art then, Sony Medical Systems has even more recently produced four new operating room devices. Today, when surgeons need a camera for microscopy they can use a camera like the DXC-C33. Its camera head measures just an inch-and-a-half square and it weighs only 48 grams.

“The big benefit of this camera is its size and ability to put out a digital signal across a Sony i.LINK® interface to a compatible device,” explains Paul Kasparian, marketing manager of Sony Medical Systems’ digital video products. To output the compressed digital video signal, the camera uses the IEEE 1394 digital interface, otherwise known as i.LINK. The i.LINK interface allows the camera to be directly connected to a DVCAM™ recorder; the same interface allows the DVCAM recorder to connect directly to a computer. Compatible with both PC and Macintosh® computers, the camera also provides several other types of video signal output, including RGB, Y/C, and composite video.

“Space being at a premium in a surgical environment, the camera is very small and thin,” says Kasparian. While brain surgery is one application of the DXC-C33, the most common application is eye surgery. “The intended marketplace for the camera is surgical microscopy, and eye surgery is a major part of the surgical microscopy market,” Kasparian explains. The camera boasts a stunning 850 lines of resolution, and when connected to a DVCAM recorder via the i.LINK interface, the recorded video is a virtually identical representation of the camera’s original picture.

THE IMAGER

From the camera, the image can be sent to a device like the UPA-P100MD, a Digital Image Capture Unit. What the UPA-P100MD does is capture and digitize images from video cameras, and makes the images available to doctors through several methods. These methods include printouts, burning the images on a CD disk, or transporting the images over a network system. The UPA-P100MD enables doctors to instantly consult with other surgeons and physicians.

What’s more, the UPA- P100MD is extremely lightweight, weighing just 12 pounds, and has a direct printout capability. And it boasts a 20-gigabyte hard drive that can store up to 15,000 images. The images can also be accessed through a hospital’s computer network. Also, after being burned on a CD, doctors can attach the images to e-mail (the images can be recorded in JPEG and TIFF formats, which are compatible with nearly all hospital computer systems), insert them into medical reports, and use them for PowerPoint® presentations.

THE MONITOR

The output of the camera is sent directly to a medical grade monitor where it can be viewed by the surgeon or surgeons performing the procedure. The monitor that many surgeons can now use is a Sony LMD-181MD, which Sony designed specifically for use in hospitals and especially in operating
rooms. In other words, you won’t see CNN or reruns ofGilligan’s Island on it. With the LMD-181MD, the nursing staff could monitor a patient’s vital signs: the pulsating line shows the heart beating in real time (fascinating to watch when you’re sick as a dog); blood pressure and respiration; and a numerical output of the heart rate.

The monitor is an 18-inch (viewable area, measured diagonally) high-performance flat-panel display. And thismulti-format display has twice the definition of a standard video monitor. What’s more, it is a medical grade monitor. That means it’s made to prevent interference with any of the other electronic equipment in the operating room. And not only that, it has a higher degree of protection from electrical shock than standard monitors (which the patient naturally appreciates).

And the monitor has more uses than just displaying the images from an endoscopic camera. “It can show X-rays of what the doctor sees,” says John Wyckoff, a marketing manager for Sony Medical Systems. “Customers hook them up to endoscopes, and they show data on them like heartbeats, ultrasounds, X-rays, and other things. It’s a window for whatever the doctor wants to use it.”

They can also attach a videocassette recorder to the monitor to record the operation for review later. And in case during the operation the patient is spraying brain fluid around the room, the controls have splash protection. “All external buttons have a membrane across the control panel,” says Wyckoff. “Anywhere doctors need a high-resolution viewing device capable of multiple different inputs, the LMD-181MD does the job better than any other screen.”

THE PRINTER

One tool that the doctors did not have available during my brain operation—but I wish they had, considering how rapidly my health deteriorated—was the UPD-71XR, an incredibly powerful medical printer. According to Evan Krachman, Sony MedicalSystems’ marketing manager for dry film
imagers and printers, the UPD-71XR is a completely new device, just introduced to the medical world. “When you come out of an MRI or a CAT scan the technicians must process the film. This particular printer is the same concept—it can print on X-ray film. But they’re not chemical images.” That is, traditional film designed specifically for medical use, such as X-rays, traditionally depends on a silver process, much like black-and-white film. The UPD-71XR is situated inside a cart and the CAT scan images are printed on it. Many hospitals and imaging centers still use traditional wet process X-ray film printers, which require several minutes to produce an image and also create chemical waste that must be treated and disposed of properly. The UPD-71XR resolves the image at 325 dpi, and it can instantly take the digital signal and print on transparent film or paper in less than 45s e c o n d s . This is a dry process that does not involve chemicals. Dry film imaging will save hospitals millions of dollars per year. The printer includes a built-in anti-shock system, which protects the print head when technicians move the system. It’s also automatic, which means all the user has to do is flip the power switch. In fact, it’s the first new printer specifically developed for the radiology market.

THE REWARDS

Sony Electronics has recently received several awards for its medical systems. It took home the prestigious 2001 Frost & Sullivan Market Engineering Leadership Award for Printers, Monitors and Recorders. The Award is given annually to “the company that has exhibited market share leadership through the implementation of market engineering strategy.” Plus, Sony Medical Systems rated 14th on Medical Imaging magazine’s top 20 “Leaders of the Pack.” And the greatest award of all: Sony Medical Systems’ equipment assists in saving people’s lives.