title: Live video manipulator for endoscopy and natural orifice transluminal endoscopic surgery (with videos).
abstract: 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.
  
  
  METHODS
  Prospective ex vivo and in vivo feasibility study.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Division of Digestive and Liver Diseases, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
authors.forename: Shou-Jiang
authors.initials: SJ
authors.lastname: Tang
authors.forename: Richard
authors.initials: R
authors.lastname: Bergs
authors.forename: Saad F
authors.initials: SF
authors.lastname: Jazrawi
authors.forename: Christopher O
authors.initials: CO
authors.lastname: Olukoga
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Caddedu
authors.forename: Raul
authors.initials: R
authors.lastname: Fernandez
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Scott
mesh_terms: D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D004867:Equipment Design; D004869:Equipment Safety; D005240:Feasibility Studies; D005260:Female; D005471:Fluoroscopy / Q000379:methods; D006801:Humans; D007089:Image Enhancement / Q000295:instrumentation* / Q000379:methods; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014741:Video Recording / Q000379:methods*; D020535:Video-Assisted Surgery