High Definition Laparoscopy: Objective Assessment of Performance Characteristics and Comparison with Standard Laparoscopy

Introduction: High definition (HD) digital imaging represents a major advance in endoscope technology. The development of the charge-coupled device chip and its location at the distal end of the endoscope allows for image capture and digitization, as well as specific light filtration and processing. We assessed the capability of HD technology combined with digital imaging to provide improved image quality and enhanced spatial three-dimensional positioning. Methods: A HD digital laparoscope and a standard definition (SD) laparoscope were evaluated in the laboratory setting to assess and compare image resolution, brightness, contrast, and color reproducibility, using standard industry testing protocols. Results: Compared with the SD laparoscope, the HD laparoscope had superior resolution at 50mm distance (2.4 line pairs/mm v 2.0 line pairs/mm), increased image brightness (129 lumens v 112 lumens), increased depth of field, and decreased distortion. Color and grayscale reproduction were found to be similar for the two laparoscopes. Conclusion: HD laparoscopy has superior objective performance characteristics compared with standard laparoscopes. Further investigation is required to determine whether these objective findings translate into subjective improvements, and which characteristics can be adjusted to obtain the best possible results. These improved optics may lead to easier identification of anatomic structures, finer dissection, and enhanced three-dimensional spatial positioning during HD laparoscopic procedures.