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NOSCAR 2010 Targeted Technology Assessment. Imaging & Optics. Imaging & Optics. Variable focal length scopes Depth of field of view, full size image rather than cropped or field size image Provide near view and far view Enhance safety and efficacy
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NOSCAR 2010Targeted Technology Assessment Imaging & Optics
Imaging & Optics • Variable focal length scopes • Depth of field of view, full size image rather than cropped or field size image • Provide near view and far view • Enhance safety and efficacy • Incorporate laparoscopic lens system into flexible endoscope (dedicated NOTES endoscope) • Zoom function • Timeline immediate • No obstacles to adoption
Imaging & Optics • Disassociation of image optics form instrumentation • Permits therapeutics beyond the linear axis of the flexible endoscope • Multiple angles, panoramic, rear view image • Pop-up cameras, implantable tripods, magnetic, etc • Benefits of triangulation • Separate operators of imaging and therapeutics • 1-2 yr timeline • Obstacles to adoption • Cross camera glare, reflection, disorientation
Imaging & Optics • Variable stiffness NOTES endoscope • Permit stiffening and flexibility • Configurational conformity • Fixed axis for intervention • Smart imaging • Beyond HD white light imaging • Electronic enhancements (NBI, FICE, MBI) • Fluorescence, infrared, thermography
Imaging & Optics • Lens cleaning systems • Adoption of flexible endoscope wash systems to laparoscopes • Enhance efficiency • Modest cost increase Directing imaging to recesses • Illumination and imaging into hidden corners • Allow total abdominal imaging • Detect metastases • Implantable illumination systems
Imaging & Optics • Guided NOTES trochars • Optical, EUS, Mini-scopes, others • Permit reliable, reproducible, safe access • Applicable to trans-gastric, -colonic, -vaginal • 3-D modeling • Pre-op CT scanning for organ orientation, guided entry, strategy planning • Used in combination with scope guide for real time orientation