Video towers, also known as video carts, are essential to minimally invasive surgery. Whether they're supporting flexible scope gastrointestinal, gynecological or ENT procedures or rigid scope arthroscopy and laparoscopy, they're a surgeon's eyes, providing live images from inside the operative area. They're also a substantial capital investment. Given the technology options available, it's easy to spend upwards of $100,000 on a new tower or several times that if you're outfitting more than one OR. Here are a few tips to help you make the most of a monumental equipment purchase.
Arthrex, Inc.
C3 (Comprehensive Cost
Containment) Program
(800) 933-7001 x1238
www.arthrex.com
Price: based on customized specifications
FYI: The Arthrex C3 Program offers high performing digital video technology, improved surgical performance, greater OR efficiency and revolutionary reductions in per-procedure operating costs, says the company. The exclusive distributor of Olympus Imaging Systems for orthopedic specialty centers, Arthrex ensures that customers have access to the latest digital video technology.
|
ConMed Linvatec
IM3300 Enhanced Definition
3CCD Camera System
(800) 237-0169
www.conmed.com
Price: $24,960
FYI: The IM3300 system offers high-definition image quality and the convenience of steam sterilization, says the company. Its innovative design is based on years of experience with autoclavable products and incorporates a patented shockflex prism-mounting system to increase durability. The integrated optics are hermetically sealed utilizing a magnetic drive system that prevents fogging and ensures optimal image quality.
|
Fujinon, Inc.
EPX-4400 video endoscopy system
(800) 490-0661
www.fujinonendoscopy.com
Price: $33,000
FYI: Fujinon's fully digital 4400 system provides super-high resolution digital images and optional Fuji Intelligent Chromo Endoscopy on-demand wavelength technology, says the company, as well as digital image storage and retrieval. The system is compatible with the entire line of Fujinon 400 Series endoscopes. The company says its personalized service is supported by its best-in-class, locally based, Certified Service Partner network and corporate repair facility.
|
Trial inclusively
It's not uncommon for surgeons to have a key say when you're making a large capital purchase. But keep in mind the support staff, both inside and outside of the OR or procedure room, who'll be dealing with the video tower and its components. Let them have a hand in on-site trials and vendor visits, and incorporate their input.
The burden of learning and operating new equipment often rests on the OR nurses and techs. Listening to their views on new equipment now might prevent frustration during procedures later. Similarly, introducing your central processing staff to the cameras and scopes you're considering - and allowing the vendors' reps to demonstrate how these items are best cleaned and sterilized - could offer valuable insights into time and money savings after each use. Manufacturers have begun developing autoclavable scopes, and the more that can be steamed, the better.
Gyrus ACMI
Gyrus ACMI Video Tower
(888) 524-7266
www.gyrusacmi.com
Price: starts at $34,000
FYI: Gyrus ACMI is a full-service medical video provider offering the latest digital video technology and accessories, including monitors, light sources, digital documentation systems, printers and the Slimline cart for outpatient surgery suites, says the company. The system's digital color matrixing provides accurate, life-like color reproduction and its next-generation digital cameras offer the convenience of one, single-touch control.
|
Karl Storz Endoscopy America, Inc.
Karl Storz Digital Imaging Platform
(800) 421-0837
www.karlstorz.com
Price: not disclosed
FYI: The Karl Storz Digital Imaging Platform includes Image 1, the first all-digital camera system, and an image capture device with a large-format touch panel interface, the company says. The Karl Storz Communication Bus displays insufflator, light source and other vital device information directly on the endoscopic monitor. The platform's expandable serial digital interface architecture readily accepts additional devices or system expansion.
|
Olympus Surgical America
Universal Platform
(800) 548-5515
www.olympussurgical.com
Price: $15,000 to $50,000
FYI: Olympus offers the widest range of rigid and flexible endoscopic products and instrumentation, the company says. The new HDTV Universal Platform (available in April 2006) allows for the standardization of all endoscopic applications using just one system. The Exera II system offers support for all specialty and procedural needs.
|
Pentax Medical Company
Pentax Video Systems (EPK-1000 pictured)
(800) 431-5880
www.pentaxmedical.com
Price: Starting at $30,000
FYI: Pentax's video systems provide unsurpassed image quality and state-of-the-art video technology for the GI, pulmonology, urology and ENT fields, says the company. The video endoscope joins a compact video processor and medical grade or broadcast quality monitor, and can be enhanced with image management, real-time video capture and editing software, for complete image and data management in the endoscopy suite.
|
Richard Wolf
Medical Instruments
Riwo-Net Integrated Video Cart
(800) 323-9653
www.richardwolfusa.com
Price: not disclosed
FYI: The Riwo-Net offers centralized control of video components, including a 3CCD endocam, high flow insufflator, light source and peripherals, via a touch screen monitor or voice control, says the company. The mobile cart features large handles for maneuverability, adjustable shelves and arms, a stable aluminum profile with an integrated power strip, integrated cable channels and an isolation transformer for safety.
|
Plan for portability
In my recent surveys of the product field, I haven't seen many video towers at all that don't have flat-panel monitors. This is good news. The graphic resolution - and, as a result, the visual clarity - of flat-panel monitors is much improved over traditional cathode ray tubes. They're also easier to move than heavy CRT monitors.
If your equipment budget won't accommodate a video tower in every OR and procedure room, you're going to have to move the towers you buy. Once a tower is in the room, it'll have to be moved and shifted still more depending on the procedure, the position of the surgeon and anyone else who needs a view. Be sure to test the maneuverability of the towers you're trialing, as well as how they fit among the other equipment and visitors in your rooms. If the tower's going to be a semi-permanent fixture in a room, would additional monitors increase visibility? And would a ceiling-mounted boom system make for more efficient access, mobility and use of space?
Consider buying a demo
Next to the availability and response of a manufacturer's service, price is a deciding factor in many capital purchases. Buying pre-owned or refurbished equipment is one option in controlling costs. With high-technology items like video towers, however, it's possible that new advances could quickly outstrip the used model's dated technology.
One alternative is to buy a demonstration model. Demos are typically current models that were taken off the warehouse floor, visited a few hospitals and conference exhibit halls and have accumulated about 10 or 20 hours' use. You might be able to get one for 10 percent to 15 percent less than what you would have paid for a new model. If it's covered under the same warranty, it's the next best thing to new, so be sure to ask that, too.
While you're considering price, remember also to budget the cost of extra supplies the video tower will need, particularly in terms of output and recording. Recordable DVDs don't cost much, but your video printers for still photos will require special paper and ink cartridges, and they're not inexpensive supplies to stock in your inventory.
Limit your purchase
Typically, the components of a video tower include the camera, its light source, a CO2 insufflator, one or more monitors, the printer and DVD recorder and the software that runs the system. That seems simple enough, until the surgeons of one specialty demand one manufacturer's model, while the surgeons of another group decide they like something else entirely. If your budget allows for the purchase of more than one tower, you might be tempted to buy each group its first choice. There are compelling reasons, though, that you should narrow your purchase down to one vendor only.
Getting physicians to agree on one choice of equipment will require more than a little diplomacy. But remind them that buying more equipment from a single vendor will help you score discounts from that vendor. Also, the more you can keep your equipment alike from room to room, the easier it is for your staff to adapt and work efficiently in any given room. Finally, the towers themselves will be more compatible to the use demanded of them should one break down and the other(s) need to be shared.
Skytron
Ergon Central Tandem Skyboom
(800) SKY-TRON
www.skytron.us
Price: $22,000 to $28,000
FYI: Skytron's Central Tandem Skyboom provides the perfect balance between compact design and cutting-edge function, says the company. Mounted with surgical lights, the boom can be equipped with MIS equipment, CO2 for insufflators, medical gases, power and video outlets and a separate monitor arm for independent positioning. The system provides up to 16 feet in reach for positioning around the entire periphery of the sterile field for any procedure.
|
Smith & Nephew Endoscopy, Inc.
Digital OR
(800) 544-2330 x6337
www.smith-nephew.com/dor
Price: not disclosed
FYI: The Digital OR platform from Smith & Nephew is an integrated operating room solution utilizing emerging digital technologies for the benefit of the patient and surgical team, says the company. The revolutionary products are integrated into customized, modular and upgradeable systems that are designed to deliver superior performance and improved efficiency.
|
Stryker Endoscopy
1088 HD Camera and Video System
(800) 624 4422
www.stryker.com
Price: $60,000 to $80,000
FYI: Stryker Endoscopy offers a full line of three-chip and one-chip cameras, light sources and video accessories to the minimally invasive surgical market. The 1088 HD system brings high definition resolution to minimally invasive procedures, says the company, providing two-thirds more information and progressive scan technology for true-to-life color reproduction, improved motion control and visual clarity enabling precise surgical movements.
|
|
Input Vital to Purchasing Video Equipment
|
It's entirely possible that video towers will be one of the largest capital purchases your center or department makes. Choosing a vendor, selecting the system's components and negotiating a purchasing contract may also consume an enormous amount of time. That's why it's important to bring an interdisciplinary team into the process. Its resources and input can help make the purchase and implementation a success.
As we began planning to update our video towers, we assembled our materials management director, a biomedical technician, and members of our OR staff and management. Together we were able to discuss options and identify potential conflicts even before we trialed the equipment.
Our materials manager, for instance, provided valuable vendor-specific insights, such as GPO participation and previous facility purchases that leveraged our buying position in contract negotiations. She also reported the impact that the new equipment's options would have on our operating budget, like the fact that multiple video printers would require a variety of expensive printer paper in our inventory.
In another instance, our biomed technician realized that digital image storage devices would change the image quality delivered by the camera to the monitor and was able to explain this drawback to the clinical staff. As a result, we decided against including those devices in our tower upgrade.
After we narrowed the field of vendors to three options under consideration, we scheduled a weeklong trial with each. While it may not be realistic to expect that every surgeon will be able to try the equipment during that time, you should be able to get a service line perspective on each.
We scheduled our trials in rooms that had targeted cases or surgeons with unique clinical needs that we'd have to meet. We made sure that each surgeon and staff member completed a written feedback form evaluating each equipment set on image quality, service and ease of use. After each vendor had completed a week in the OR, we evaluated the feedback forms and compared the results. Since many surgeons and OR staff are data-driven, present the results of their evaluations as graphs.
During our trials, service and price became our decision makers. While it was obvious which vendor had the better price, our biomed technician was able to judge which provided the better service. Your materials manager can lead or assist in the contract negotiations, while clinical input is critical in assessing the component portions of the contract.
Schedule with your vendor an implementation week to follow the equipment's delivery, unpacking and biomed check-in. Ours began on Sunday, when the OR was quiet, and we converted our equipment over eight hours. There was an in-service and hands-on training for staff Monday morning, and two vendor representatives provided round-the-clock coverage that week. Our clinicians were comfortable with the equipment, and we had support as needed.
- Lori Robertson, RN, CNOR, BBA
Ms. Robertson ([email protected]) is assistant director for perioperative services at Rockingham Memorial Hospital in Harrisonburg, Va.
|
.svg?sfvrsn=be606e78_3)
.svg?sfvrsn=56b2f850_5)