title: Virtual digital defogging technology improves laparoscopic imaging quality.
abstract: BACKGROUND
  The aim of this study was to evaluate the effects of a newly developed digital defogging (DD) system on imaging quality in laparoscopic surgery. Lens fogging instantly degrades image quality and interrupts the flow of surgical maneuvers during laparoscopic surgery. To address this problem, we developed a DD system based on the dark channel prior.
  
  
  METHODS
  Two hundred patients with gallstones or right colon cancer were enrolled in this study. Of the 100 patients who underwent laparoscopic cholecystectomy, 50 used a regular monitor (group A) while the other 50 used a DD monitor (group B). Of the 100 patients who underwent laparoscopic colectomy, the regular monitor was used for 50 (group C) and the DD monitor was used for the other 50 (group D). The clarity of images, the ratio of lens-cleaned time to operative time, and the subjective anxiety of the surgeons were evaluated for all cases.
  
  
  RESULTS
  There were significant differences (P < .05) in the clarity of images between groups C (2.68 ± 1.19) and D (1.98 ± 1.00) and the ratio of lens-cleaned time to operative time between groups C (5.22 ± 0.89) and D (4.14 ± 0.85). Moreover, the DD system significantly reduced the subjective anxiety of the surgeons (P < .001) in colectomy procedures, compared with the regular monitor.
  
  
  CONCLUSIONS
  The DD system can export a dynamic stable image to the monitor during laparoscopic surgery, which can result in shorter operative time with less surgeon anxiety.
authors.affiliation: Department of Gastroenterology Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, People's Republic of China.
authors.forename: Lei
authors.initials: L
authors.lastname: Gu
authors.affiliation: School of Electronic Information and Electronic Engineering, Shanghai Jiaotong University, Shanghai, People's Republic of China.
authors.forename: Peilin
authors.initials: P
authors.lastname: Liu
authors.affiliation: Department of Gastroenterology Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, People's Republic of China.
authors.forename: Chunhui
authors.initials: C
authors.lastname: Jiang
authors.affiliation: Department of Gastroenterology Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, People's Republic of China.
authors.forename: Meng
authors.initials: M
authors.lastname: Luo
authors.affiliation: Department of Gastroenterology Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, People's Republic of China xuqing@renji.com.
authors.forename: Qing
authors.initials: Q
authors.lastname: Xu
mesh_terms: D000328:Adult; D000368:Aged; D002763:Cholecystectomy / Q000379:methods; D003082:Colectomy / Q000379:methods; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000295:instrumentation / Q000379:methods*; D010535:Laparoscopy / Q000295:instrumentation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D025321:Surgery, Computer-Assisted / Q000295:instrumentation / Q000379:methods*; D055815:Young Adult
keywords: cholecystectomy; colectomy; digital defogging system; laparoscopy; lens fogging